CN103517677A - Apparatus and methods for bone repair preparation - Google Patents

Abstract

The application relates to an apparatus and methods for preparing a fractured bone for repair. Preparing the bone may include fracture reduction. Preparing the bone may include holding a fracture in reduction. Preparing the bone may include identifying locations for obtaining access to an interior region of the bone. The apparatus may include structures outside the bone that interact with fragments of the bone. The structures may participate in the reduction. The structures may participate in holding the reduction. The structures may participate in identifying the locations.

Description

The apparatus and method of preparing for bone reparation

The cross reference of related application

The application is the non-provisional application of U.S. Patent application No.61/450112, and the applying date of this U.S. Patent application No.61/450112 is on March 7th, 2011, and all files of the document is in conjunction with in this application, as a reference.

Technical field

Aspect of the present invention relates to the apparatus and method that are provided for repair of fractures.Particularly, the present invention relates to for the preparation of fractured bones to receive the apparatus and method for the treatment of implantation piece.

Background technology

Be anchored at bone section in rigid support fixing may the comprising of fractures, and this rigid support is outside or inner bone.Conventionally, supporting member comprises: (a) plate, and this plate bolt is connected to the outside of bone; And (b) implantation piece, it is inner that this implantation piece inserts bone.

The treatment of supporting member is used and is relied on reseting fracture portion and in applying the process of supporting member, keep this reset.Conventionally, clinician inserts pin in bone section, and by directly near anatomical structure fractures being moved and reseting fracture portion with hands.Then, another clinician uses completely outside pin (pin of this outside extends between the pin inserting) to support this pin again in being called the processing procedure of external stability.Whole pin is externally connected at link place with inner pin, and this link fixes by hold-down screw.

Adopt direct labor's reset and fulcrum post (passing through connecting portion) that the limited control to bone section location is provided, and may relate to a large amount of human tasks, these human tasks may be difficult to efficiently realize the mode resetting with correct hold reset and coordinate.

Therefore be desirable to provide a kind of for the preparation of fractured bones so that the apparatus and method of repairing.

Accompanying drawing explanation

In the following detailed description and by reference to the accompanying drawings, will know objects and advantages of the present invention, in whole accompanying drawings, same reference numerals represents same parts, and in accompanying drawing:

Fig. 1 has represented the anatomical structure that the present invention can implement.

Fig. 2 A has represented a part for the anatomical structure shown in Fig. 1.

Fig. 2 B has represented anatomical structure and the descriptive information shown in Fig. 2 A.

Fig. 3 A has represented the partial sectional view of the anatomical structure shown in Fig. 2 A.

Fig. 3 B has represented the device that the present invention can implement.

Fig. 4 has represented the processing procedure that the present invention can implement.

Fig. 5 has represented another processing procedure that the present invention can implement, and this processing procedure relates to the anatomical structure shown in Fig. 2 A and other anatomical structure.

Fig. 6 has represented and the similar anatomical structure of anatomical structure shown in Fig. 2 A (in the situation with different shown in Fig. 2 A) and device.

Fig. 7 has represented the signal anatomical structure that the present invention can implement.

Fig. 8 has represented a part (at the state from different shown in Fig. 1) for the anatomical structure shown in Fig. 1.

Fig. 9 has represented that the anatomical structure shown in Fig. 8 is at the state from different shown in Fig. 8.

Figure 10 has represented exemplary device in accordance with the principles of the present invention.

Figure 11 has represented another exemplary device in accordance with the principles of the present invention.

Figure 12 A has represented the anatomical structure shown in the device shown in Figure 10 and Fig. 8.

Figure 12 B has represented a part for the device shown in Figure 10.

Figure 12 C has represented shown in the 12C-12C(Figure 10 along the line of the device shown in Figure 10) cutaway view.

Figure 13 has represented in accordance with the principles of the present invention an also device.

Figure 14 has represented a part for the device shown in Figure 13.

Figure 15 has represented a part for the device shown in Figure 14.

Figure 16 has represented a part for the device shown in Figure 15.

Figure 17 has represented a part for the device shown in Figure 14.

Figure 18 has represented to represent in the 18-18(Figure 17 along the line of the device shown in Figure 17) cutaway view.

Figure 19 has represented another part of the device shown in Figure 13.

Figure 20 has represented to represent in the 20-20(Figure 13 along the line of the device shown in Figure 13) cutaway view.

Figure 21 has represented in accordance with the principles of the present invention an also device.

Figure 22 has represented a part for the device shown in Figure 21.

Figure 23 has represented to represent in the 23-23(Figure 21 along the line of the device shown in Figure 21) cutaway view.

Figure 24 has represented a part for the device shown in Figure 21.

Figure 25 has represented the transparent view of a part for the device shown in Figure 21.

Figure 26 has represented the device of Figure 13 and the anatomical structure shown in Fig. 6.

Figure 27 has represented in accordance with the principles of the present invention an also part for the anatomical structure shown in a device and Fig. 8.

Figure 28 has represented in accordance with the principles of the present invention an also device.

Figure 29 has represented the device of Figure 28 and a part for the anatomical structure shown in other device and Fig. 8.

Figure 30 has represented in accordance with the principles of the present invention the also device shown in a device and Figure 27.

Figure 31 has represented information in accordance with the principles of the present invention.

Figure 32 has represented in accordance with the principles of the present invention an also device.

Figure 33 has represented in accordance with the principles of the present invention an also device.

Figure 34 has represented the device of Figure 32 and 33.

Figure 35 has represented information in accordance with the principles of the present invention.

Figure 36 has represented in accordance with the principles of the present invention an also part for the anatomical structure shown in a device and Fig. 8.

Figure 37 has represented in accordance with the principles of the present invention an also device.

Figure 38 has represented in accordance with the principles of the present invention an also device.

Figure 39 has represented in accordance with the principles of the present invention also device and an anatomical structure.

Figure 40 has represented the device of Figure 39 and anatomical structure and other device in accordance with the principles of the present invention.

Figure 41 has represented in accordance with the principles of the present invention an also device.

Figure 42 has represented a part for the device shown in Figure 41.

Figure 43 has represented a part for the device shown in Figure 42.

Figure 44 has represented to represent in the 44-44(Figure 42 along the line of the device shown in Figure 42) cutaway view.

Figure 45 has represented the device shown in Figure 42 and other device in accordance with the principles of the present invention.

Figure 46 has represented in accordance with the principles of the present invention an also device.

Figure 47 has represented in accordance with the principles of the present invention an also device.

Figure 48 A has represented in accordance with the principles of the present invention also device and an anatomical structure.

Figure 48 B has represented in accordance with the principles of the present invention also device and an anatomical structure.

Figure 49 has represented the device of Figure 48 A, and the structure of this device is different from the structure shown in Figure 48 A.

Figure 50 has represented a part for the device shown in Figure 48 A.

Figure 51 has represented in accordance with the principles of the present invention an also device.

Figure 52 has represented in accordance with the principles of the present invention an also device.

Figure 53 has represented a part and the anatomical structure of the device shown in Figure 52.

Figure 54 has represented a part and the anatomical structure of the device shown in Figure 52.

Figure 55 has represented a part and the anatomical structure of the device shown in Figure 52.

The specific embodiment

Here provide for the preparation of fractured bones so that device and the system for the treatment of.

Bone can have one section, two sections, three sections or multistage more.(fractured bones of a section can have fractures, and this fractures does not make bone be separated into two or more sections completely.) bone can repair with implantation piece and one or more anchoring piece, to bone section is fixed on implantation piece.

Preparation for the bone repaired can comprise: the reset of fractures; Fractures is remained in resetting structure; At the inner position of selecting for implantation piece of bone; Select for bone enter Kong position, implantation piece enters hole by this and supplies with bone inside; Open this hole; The cavity of clean internal; And other appropriate steps arbitrarily.At all files of the U.S. Patent application No.US20090182336, the US20110178520 that own together, US20110190832, US20110218626 and these documents of US20110218585(in conjunction with in this application, as a reference) shown in and described apparatus and method all represented the apparatus and method that can use in conjunction with some abovementioned steps.

The reset of fractures can comprise and make bone section along quadrature-axis translation and rotate around quadrature-axis, and this quadrature-axis has initial point in bone section.For example, clinician can so that bone section with respect to axis translation or rotation (or translation and rotation), to handle bone section to making bone section can be anchored at implantation piece Shang position.When bone section, locating like this Shi，Gai position can fix, to prepare bone section, is used for being anchored at implantation piece.

Clinician can locate bone section by handling anatomical structure in the situation that not piercing through skin.

Clinician can locate bone section by bone penetrating parts.Can use some apparatus and method for this reason.Bone penetrating parts can be for elongated, and have first end, and this first end penetrates bone section and forms interference engagement with this bone section.Bone penetrating parts can have the second end, and this second end can be handled and leave bone.Bone penetrating parts can pierce through skin.Bone penetrating parts can penetrate bone (skin is removed from this bone).

Clinician can fix the first bone section with respect to the reset position of the second bone section by bone penetrating parts being fixed in the second bone section.The second bone section can engage with anatomical structure naturally, for example, engage with instrument of skeleton anatomical structure, makes the second bone section relatively stable.The second bone section can be used as " reference " bone section, for resetting and estimate for example location of the first bone section in conjunction with fractures.

The first and second bone sections can be handled by corresponding the first and second bone penetrating parts.The first and second bone penetrating parts can be in the situation that do not have the help of external device (ED) to handle.The first and second bone penetrating parts can be handled ordinatedly with external device (ED).External device (ED) can be fixed the first and second bone penetrating parts positions relative to each other.When being arranged to the one or more fractures of crosscut, the first and second bone penetrating parts can be fixed the reset position of the first and second bone sections in the situation that the first and second bone penetrating parts do not interfix.

External device (ED) can support one or more other external device (ED)s, for select implantation piece at the position of bone inside, be chosen in entering Kong position (implantation piece enters hole by this and is sent to bone inside), opening the cavity, configuration implantation piece of this hole, clean internal and other suitable step or processing procedure arbitrarily of bone.The Surigical tool that can use in conjunction with these steps can comprise saw, brill, line, borer and other suitable Surigical tool arbitrarily.

Device can comprise with method can relate to external device (ED).

Device can comprise that ray can permeable material exclusively.Device can comprise ray non-permeate material exclusively.Device can comprise that ray can permeable material and ray non-permeate material.

In certain embodiments, device can comprise with method and can relate to the device for the fractures of the bone that resets.Device can comprise the first bone piercing elements.Device can comprise the second bone piercing elements.Device can comprise bridging element.Bridging element can be configured in bone outside.Bridging element can be configured to receive the first bone piercing elements and the second bone piercing elements.Device can comprise maintaining body, this maintaining body be arranged to keep the first bone piercing elements with respect to the primary importance of bridging element and the second bone piercing elements the second position with respect to bridging element.

Maintaining body can comprise elongated pressure distribution parts, and these pressure distribution parts are arranged to exert pressure to the first bone piercing elements and the second bone piercing elements.Pressure distribution parts can remain on the first bone piercing elements primary importance and the second bone piercing elements be remained on to the second position.

Device can comprise fixed mechanism, and this fixed structure is arranged to pressure to send to a part for pressure distribution parts, so that pressure distribution parts remain on the first bone piercing elements primary importance and the second bone piercing elements is remained on to the second position.

Fixed mechanism can comprise hold-down screw.

Device can comprise the 3rd bone penetrating parts and base portion.The 3rd bone penetrating parts can be arranged so that base portion and engage with reference to bone section.The first bone penetrating parts can be arranged so that the first bone section with respect to locating with reference to bone section.

Base portion can comprise the axle collar, and this axle collar is configured to receive the 3rd bone penetrating parts.

Device can comprise height lock, the height for fixed base with respect to bone.

Device can comprise length lock, for being fixed on the length between bridging component and the axle collar.

The second bone penetrating parts can be arranged so that the second bone section with respect to locating with reference to bone section.

Device can comprise supporting member, and this supporting member is arranged so that base portion and bridging element are rigidly connected.This supporting member can be defined for recess and the companion devices of the magnetography of bone.A part for recess can be basically identical with the longitudinal axis of bone.

Device can comprise that ，Gai articulated section, articulated section makes supporting member be connected with bridging element.Device can comprise hinged lock, and this hinged lock is arranged to bridging component to be fixed on the angle of inclination with supporting member.

Device can comprise general frame.This framework can comprise: the first receptor, for receiving the first bone piercing elements; The second receptor, for receiving the second bone piercing elements; And the 3rd receptor, for receiving the 3rd bone piercing elements.

The first and second bone piercing elements can be arranged to make respectively the first and second bone sections to move with respect to the 3rd bone section, and the 3rd bone Duan Yu tri-bone piercing elements are corresponding.The first receptor and the second receptor can limit the First Line that originates from the first receptor; The first receptor and the 3rd receptor can limit the second line that originates from the first receptor; The first and second lines define acute angle.

This angle can be in the scope from about 40 ° to about 89 °.This angle can be in the scope from about 45 ° to about 80 °.This angle can be in the scope from about 55 ° to about 75 °.

The first receptor and the second receptor can be corresponding to the first and second anatomical structure half spaces of bone, and the first anatomical structure half space is separated by the plane of substantially dividing bone equally.The first anatomical structure half space can be anterior half space, and the second anatomical structure half space can be rear portion half space.The first anatomical structure half space can be palmar half space, and the second anatomical structure half space can be dorsal part half space.The first anatomical structure half space can be middle half space, and the second anatomical structure half space is sidepiece half space.

Anatomical structure plane or viewing plane (for example anterior-posterior and in m-sidepiece) can illustrate apparatus and method for example.It should be known that anterior-posterior plane is perpendicular to the plane of the axis extending from front to back in anatomical features.It should be known that m-sidepiece plane is perpendicular to the plane of the axis extending to sidepiece from centre in anatomical features.

The 3rd receptor can be corresponding to substantially dividing bone equally and defining the plane of the first and second anatomical structure half spaces of bone.The first anatomical structure half space can be anterior half space, and the second anatomical structure half space can be rear portion half space.

The first anatomical structure half space can be palmar half space, and the second anatomical structure half space can be dorsal part half space.The first anatomical structure half space can be middle half space, and the second anatomical structure half space is sidepiece half space.

Method can comprise the method for reseting fracture portion.The method can comprise: the first bone penetrating parts is inserted in the first bone section; The second bone penetrating parts is inserted in the second bone section; And the first bone penetrating parts and the second bone penetrating parts will be distributed to from the latching force of actuator, to the first bone penetrating parts and the second bone penetrating parts are locked on bridging component, this bridging component is across to the second bone penetrating parts from the first bone penetrating parts.

Method can comprise and makes bridging component rotation to the angle of inclination with respect to the longitudinal axis with reference to bone section.Angle can be radius inclination angle.

Method can comprise by base portion pin is connected to reference in bone section, bridging component Yi Gai angle of inclination being fixed.This base portion can be rigidly connected with bridging component.

Method can comprise that adjusting base portion is with respect to the height with reference to bone section, to make the first and second bone sections with respect to rotating to certain angle with reference to bone section.Angle can be palmar inclination angle.Method can comprise level altitude, so that fixed angle.

Method can comprise adjusting and the position of the 3rd bone penetrating parts engaging with reference to bone section with respect to base portion, to be adjusted in (a) first and second bone sections; (b) with reference to the distance between bone section.

This distance can be corresponding to radius height.

Method can comprise that fixedly the axle collar is with respect to the position of base portion, so that fixed range.

Method can comprise: with the supporting member of tool jagged rigidity ray impermeable, come with respect to reference to bone fixed bridge relay part; And the inside of carrying out imaging bone by recess.

Device can comprise: base portion, and this base portion is arranged to be fixed in the first bone section; And osteocomma manipulator.This osteocomma manipulator can be communicated with base portion machinery.Osteocomma manipulator can be arranged to: with the second bone section positive engagement; The second bone section is moved along three quadrature-axis; And make the second bone section along each axis rotation in three quadrature-axis.

Device can comprise pressure source, and this pressure source is arranged to fixedly manipulator, to substantially prevent: the second bone section moves along three quadrature-axis; And second bone section around three quadrature-axis, rotate.

Osteocomma manipulator can comprise: elongate bone penetrating parts; And the axle collar, this axle collar is configured to receive elongate bone penetrating parts.Osteocomma manipulator can comprise pressure source, and this pressure source is arranged so that bone penetrating parts locks with respect to the axle collar.Osteocomma manipulator can comprise collar receiver part, and this collar receiver part is arranged to along following direction translation: first direction; And the second direction vertical with first direction.Osteocomma manipulator can comprise pressure source, and this pressure source is arranged so that the axle collar locks with respect to collar receiver part.

Osteocomma manipulator can comprise pressure source, and this pressure source is arranged so that collar receiver part locks with respect to base portion.

Pressure source can be arranged so that the axle collar locks with respect to collar receiver part.Pressure source can be arranged so that collar receiver part locks with respect to base portion.

Pressure source can be the first pressure source.Device can comprise the second pressure source, and this second pressure source is arranged so that collar receiver part locks with respect to base portion.

The axle collar can comprise cartridge clip.This cartridge clip can comprise hinged surface, and this hinged surface is hinged with respect to collar receiver part.Pressure source can comprise the screw thread of cartridge clip.Hinged surface can comprise substantially spherical curvature.

Cartridge clip can comprise sleeve body, for receiving elongated bone penetrating parts.Sleeve body can comprise external screw thread.Sleeve body can comprise maintenance finger.Keep finger can be arranged to keep elongate bone penetrating parts.Sleeve body can comprise convergent shape part, for receiving sleeve body, and makes to keep finger to press elongate bone penetrating parts.Sleeve body can comprise interior threaded part, for engaging with external screw thread, and sleeve body is directed in convergent shape part.

Interior threaded part can comprise the first crooked hinged surface, for hinged against collar receiver part.Convergent shape part can comprise the second crooked hinged surface, for hinged against collar receiver part.Convergent shape part can comprise swelling part, and this swelling part is arranged to response by keeping finger to engage with collar receiver part the joint of elongate bone penetrating parts.

Device can comprise brake, and this brake has limited in rotary moving with respect to collar receiver part of convergent shape part.Brake can comprise pin, and this pin partly stretches out from convergent shape, and is arranged to interfere collar receiver part.

Interior threaded part and convergent shape part can be arranged to by keeping finger mutually to remove facing to the power of this convergent shape part.

Collar receiver part can comprise upper board and lower panel.Interior threaded part from convergent shape partly remove can so that upper board from lower panel, remove.

Base portion can comprise framework, and this framework is arranged to limit upper board and is removed from lower panel.

Cartridge clip can be exerted pressure and (b) by collar receiver part, to framework, be exerted pressure and lock elongate bone penetrating parts to collar receiver part by interior threaded part and convergent shape part by (a).

Osteocomma manipulator can be the first osteocomma manipulator, and three quadrature-axis are corresponding to the second bone section.Device can comprise the second osteocomma manipulator, and this second osteocomma manipulator is connected with base portion machinery.The second osteocomma manipulator can be arranged to: with the 3rd bone section positive engagement; The 3rd bone section is moved along three quadrature-axis, and these three quadrature-axis are corresponding to the 3rd bone section; And make the 3rd bone section along each three quadrature-axis rotations.

Device can comprise: ductility framework; First axle collar, this first axle collar is fixed on framework, and is configured to receive the first elongate bone penetrating parts; And second axle collar, this second axle collar is fixed on framework, and is configured to receive the second elongate bone penetrating parts.Ductility framework can be arranged to keep the second elongate bone penetrating parts with respect to the position of the first elongate bone penetrating parts.

Device can comprise: the first joystick, and this first joystick and first axle collar are rigidly connected; And second joystick, this second joystick and second axle collar are rigidly connected.The second joystick can be arranged so that second axle collar moves to the second position with respect to first axle collar from the primary importance with respect to first axle collar.

The first joystick in use can be connected with first axle collar, and can dismantle from first axle collar after use.The second joystick in use can be connected with second axle collar, and can dismantle from second axle collar after use.

First axle collar can comprise the first pressure source, and this first pressure source is arranged to lock the first elongate bone penetrating parts with respect to first axle collar; Second axle collar can comprise the second pressure source, and this second pressure source is arranged to lock the second elongate bone penetrating parts with respect to second axle collar.

Device can comprise: the first supporting member, and this first supporting member is arranged to support the first soft tissue, and this soft tissue is corresponding to the first bone section; The second supporting member, this second supporting member is arranged to support the second soft tissue, and this second soft tissue is corresponding to the second bone section, and the second supporting member is by joint and hinged with respect to the first supporting member; And lock, this lock is arranged to anchor tip, to be arranged on the angle between the first supporting member and the second supporting member.

Device can comprise: the first supporting member, and this first supporting member is bearing in the first soft tissue on the first supporting member; And second supporting member, this second supporting member is bearing in the second soft tissue on the second supporting member.

The second supporting member can be arranged to apply tensile force to the second soft tissue, to make the second bone section move away from the first bone section.

The second supporting member can comprise soft tissue grasper.Soft tissue grasper can be arranged to soft tissue, apply the traction of increase when the second bone section increases away from moving of the first bone section.

In certain embodiments, device can comprise and method can relate to the device for Surigical tool is located with respect to the position of fractured bones inside.

Device can comprise: pin, and this pin is arranged to penetrate the bone section of bone; And supporting member, this supporting member is arranged to hinged with respect to pin, and indicates the corresponding inlet point in Yu Gai position.

Supporting member can comprise concave surface, for hinged against pin.Supporting member can comprise indicator, is used to indicate inlet point.Supporting member can comprise sleeve fixing part, and this sleeve fixing part is configured to receive pin, and this sleeve fixing part comprises concave surface.

Supporting member can comprise sweep, and this sweep is arranged to be across to from the first anatomical structure direction of bone the second anatomical structure direction of bone.The first and second anatomical structure directions are mutually vertical.

The first anatomical structure direction can be anterior direction, the second anatomical structure direction can be third side to.The first anatomical structure direction can be anterior direction, and the second anatomical structure direction can be side direction.

The first anatomical structure direction can be rear direction, the second anatomical structure direction can be third side to.The first anatomical structure direction can be rear direction, and the second anatomical structure direction can be side direction.

The first anatomical structure direction can be dorsal part direction, the second anatomical structure direction can be third side to.The first anatomical structure direction can be dorsal part direction, and the second anatomical structure direction can be side direction.

The first anatomical structure direction can be palmar direction, the second anatomical structure direction can be third side to.

The first anatomical structure direction can be palmar direction, and the second anatomical structure direction can be side direction.

Bone section can be the first bone section.Pin is fixed on fixture, and this fixture remains on reset orientation with respect to the second bone section by the first bone section.Pin and supporting member can define spherical surface when being bonded with each other.Pin can be arranged along the radius of spherical surface.Pin can comprise tip, and the geometric center of this tip and spherical surface is basically identical.Supporting member can be arranged so that inlet point is positioned near the joining place of soft tissue spherical surface and bone.

Pin can comprise brake, and this brake defines pin and enters the maximum penetration in bone section.Pin can comprise brake, and this brake defines when supporting member and pin joint close this supporting member with respect to the minimum constructive height of bone section.Brake can be played the effect of similar vertical pad together.

Supporting member can comprise: fixture, and this fixture is arranged to close with pin joint; And ，Gai extension, extension is arranged to extend away from fixture along spherical track, until near the soft tissue its contact bone.

Extension can comprise indicator, when indicator is near bone, and this indicator indication inlet point.Indicator can be extended away from extension along the direction vertical with spherical track.

Device can comprise elongate guide part, this elongate guide Jian You end and guiding surface.Guiding piece can with supporting member mechanical coordination, like this, guiding end corresponding to inlet point, guiding surface is oriented so that Surigical tool aligns with position.

Surigical tool can be brill, saw, rotary drilling, rotative saw, k line or other suitable Surigical tool arbitrarily.Instrument can be for starting near guiding surface in inlet point Chu hole.Instrument can insert or pass the cortex of bone.After hole starts, instrument can rotate the main rotating shaft line that leaves it, so that along leading to for configuring the direction directional hole at the position of implantation piece.

Pin can comprise penetration end, and this penetration end is arranged to be arranged in bone section.Supporting member can be arranged so that guiding piece is oriented like this, makes guiding surface be oriented such that Surigical tool aligns with penetration end.

Device can be included in the first ray impermeable target on first object arm.Device can be included in the second ray impermeable target in the second target-arm.Position and inlet point can limit guiding axis; First object arm can be communicated with pin machinery.The second target-arm can be communicated with pin machinery.First object arm can be arranged to, along the first direction away from guiding axis, first object is bearing in to the first distance.The second target-arm can be arranged to, along the second direction away from guiding axis, the second target is bearing in to second distance place.This second direction can be basically perpendicular to first direction.

First direction and second direction can limit the plane crossing with position.

In certain embodiments, device can comprise with method and can relate to for interim and resetting and the device of hold reset fractures.This device can comprise for making bone section keep stable mechanism with respect to the steady component of bone.The steady component of bone can be bone section.The steady component of bone can be naturally and bone engagement.The steady component of bone can be naturally in joint and bone engagement.

Device can comprise alignment structures, so that location is for the implantation piece of bone inside.Implantation piece can be that marrow is implanted into part.Device can comprise organization protection's device.Device can comprise guide sleeve, so that guiding enters bone.Device can comprise guide sleeve, so that guiding implantation piece is in the location of bone inside.

Device can not comprise the joint of crossing over attachment means.Device can comprise the joint of crossing over attachment means.

Device can comprise navigation system, and this navigation system is arranged to the template of implantation piece.Template can be alignd with the position for implantation piece.Navigation system can be alignd with template, so that positioning surgical device is used for entering this position.

Navigation system can be alignd with location k line.

Navigation system can be arranged so that bone section screw or anchoring piece are arranged in bone section and marrow is implanted in part.

Device can comprise that can with respect to stabilization of bony, to handle bone section with control mode in place and be locked in the mechanism of correct position.

Device can comprise can be with control mode with respect to stabilization of bony with to handle bone section with respect to other bone section in place and be locked in the mechanism of correct position.

When device can be arranged in hold reset, permission is arranged in implantation piece in bone, and does not hinder inlet passage or the position of implantation piece.

In certain embodiments, device can comprise with method and can relate to for being positioned at the device that enters hole of bone.Entering hole can be for being sent to implantation piece at the internal cavities Zhong position of bone.Device can comprise: first component, and this first component is arranged in the first anatomical structure viewing plane Zhong Yu position alignment; And second component, this second component is attached on first component.When second component contacts with tissue in the second anatomical structure viewing plane substantially vertical with the first anatomical structure viewing plane, this second component is determined point organizationally and the direction of leading to position from this point.Tissue can comprise sclerous tissues, for example bone.Tissue can comprise soft tissue, for example skin and connective tissue or muscle.

First component can comprise the target of ray impermeable, for first component is alignd with position.

First component can comprise pivot pin end, the rotatably mounted framework of this pivot pin end.This framework can comprise for receiving the receptor of bone penetrating parts.Bone penetrating parts can be arranged to framework to be fixed in the bone section of bone.First component can comprise pressure source, and this pressure source is arranged so that first component fixes with respect to framework.

Device can comprise pole, and this pole is across to the second anatomical structure observation place from the first anatomical structure observation.First component and second component can be elongated.First component can away from pivot pin end support pole.This pole can be supported second component.Pole can rotatably mounted second component.Pole can lockably be supported second component.

When first component is parallel with second component, second component can be than the short certain length of first component, and this length is corresponding to (a) length of implantation piece; And (b) distance between the end of second component and the end at position.

Second component can comprise guiding tube.Guiding tube can be for being directed to Surigical tool in the inner Zhong of bone position.

Second component can have near the base portion distal openings of guiding tube, and this base portion is placed in contact the outer surface of bone.

Base portion can comprise contact, and this contact is arranged to catch surface, to prevent that base portion is with respect to surface translation.

Contact can be the first contact.Device can comprise the second contact, and this second contact is arranged to catch surface, to jointly prevent that with the first contact base portion from rotating with respect to surface.

Base portion can comprise: the first align unit, and this first align unit stretches out from the first side of base portion; And second align unit, this second align unit stretches out from the second base portion, relative with the first side side.The apparent surface that align unit can be arranged to bone engages tangently, to guiding tube is alignd with the longitudinal axis of bone.

Base portion can comprise: the first sidepiece clamping plate, and these the first sidepiece clamping plate stretch out from the first side of base portion; And the second sidepiece clamping plate, these the second sidepiece clamping plate stretch out from the second base portion, relative with the first side side.Sidepiece clamping plate can be arranged to catch the apparent surface of bone, to prevent that base portion from rotating in a circumferential direction around the longitudinal axis of bone.

Base portion can comprise the receptor for bone penetrating parts, and like this, bone penetrating parts makes base portion engage with bone.Receptor can be the first receptor, and bone penetrating parts can be the second bone penetrating parts.Base portion can comprise the second receptor for the second bone penetrating parts, and like this, the second bone penetrating parts makes base portion engage with bone.The first and second receptors can be crooked, so that the first and second bone penetrating parts are fixed on base portion on bone by skew nailing structure.

Device can comprise the target of the first ray impermeable, for the pivot pin end of first component is alignd with position.Device can comprise the target of the second ray impermeable, for base portion is alignd with position.The target of the second ray impermeable can be stretched out from base portion.The target of the second ray impermeable can be in the second anatomical structure viewing plane substantially.

Device can comprise bone penetrating parts guiding piece.This bone penetrating parts guiding piece can be supported by base portion.This bone penetrating parts guiding piece can align with guiding tube.Framework can be arranged to the first bone section to be fixed in the second bone section.Base portion can be placed in contact the first bone section.Bone penetrating parts guiding piece can be arranged to guide bone penetrating parts to enter in implantation piece through the second bone section, to the second bone section is anchored on implantation piece.

In certain embodiments, device can comprise with method can relate to the device that comprises pointer, and this pointer is corresponding to the first position on bone, the spaced apart basic evenly distance of internal point in this first position and bone.This internal point can be corresponding to the position of bone implantation piece.Device can comprise joint element, and this joint element stretches out away from pointer.Joint element can be arranged to rotate around pin, and this pin is fixed with respect to bone, and is oriented with bone angled.The variation of angle can so that pointer corresponding to the second position on bone.This second position is different from the first position, and with the spaced apart basic evenly distance of internal point.

It is basic that evenly distance can be corresponding to the length of implantation piece.

Device can comprise pointer, and this pointer is corresponding to the spaced apart basic evenly distance of the internal point in ，Gai position, Gu Shang position and bone.Internal point can be corresponding to the position of bone implantation piece.Device can comprise joint element, and this joint element stretches out away from pointer, and joint element is arranged to rotate around pin, and this pin is fixed with respect to bone.This basic evenly distance is irrelevant with the angle that pin is fixed on bone.

In certain embodiments, device can comprise and method can relate to for orthopedic tool being positioned near the position in bone inside to the device of bone outside.This device can comprise tool tray, and this tool tray defines three quadrature-axis.Tool tray can be along one or more axis translations.Tool tray can be around one or more axis rotations.Device can comprise bearing assembly.This bearing assembly can comprise platform, and this platform is arranged to away from bone location, and engages with the bone section of bone.Device can comprise adjusting rod, and this adjusting rod makes platform be connected with tool tray.

It is neighbouring at bone external support tool tray that bearing assembly can be arranged in position.Bearing assembly can be provided as and makes tool tray along the one or more axis translations in three axis, and can rotate by the one or more axis in three axis.

Adjusting rod can comprise housing.Adjusting rod can comprise the first bar, and this first bar extends to the first spherojoint tool tray from housing.Adjusting rod can comprise the second bar, and this second bar extends to the hole of platform from the second spherojoint of housing.

Housing can be by the second bar and with respect to platform translation and rotation.

Device can comprise the target of ray impermeable, and the goal setting of this ray impermeable becomes to be attached on tool tray, for tool tray is alignd with using the position of imaging of medical.

Device can comprise guiding tube.This guiding tube can comprise fixture, and this fixture is arranged to be attached on tool tray with an orientation.Guiding tube can comprise sleeve pipe, the axial alignment of this sleeve pipe based on Er Yu position, this orientation.Guiding tube can be arranged to rotation Surigical tool to guide to position.

Device can comprise bone penetrating parts guiding piece.This bone penetrating parts guiding piece can comprise fixture, and this fixture is arranged to be attached on tool tray with an orientation.Bone penetrating parts guiding piece can comprise guiding channel, the axial alignment of this guiding channel based on this orientation and position.When bone section is the first bone section, guiding channel can be arranged to guide bone penetrating parts to enter in implantation piece through the second bone section, to the second bone section is anchored on implantation piece.

In certain embodiments, apparatus and method can be used in conjunction with the bone penetrating parts that comprises vertical pad.Vertically pad can be for arranging from bone to shown in here and the height of described device.For example, use two or more such pads, fixture or framework can be bearing in the suitable even or non-homogeneous height higher than bone.

Vertically pad can provide structural stability to bone penetrating parts, and can not increase the overall diameter of bone penetrating parts.

In certain embodiments, apparatus and method can be in conjunction with comprising that the bone penetrating parts that penetrates limiter used.Penetrating limiter can be for preventing from penetrating bone or other tissue (this bone or other organize do not wish to be penetrated).

In certain embodiments, the far-end of bone penetrating parts can comprise organizes connected structure, and for example screw thread, one or more ridge, one or more rib or one or more barb, to be increased in the bond strength between bone penetrating parts and bone.This can increase can be imposed on by bone penetrating parts the strength of bone.

Below in conjunction with accompanying drawing introduction according to apparatus and method of the present invention.Feature example explanation in selected embodiment.It should be known that in conjunction with the feature shown in an embodiment can be according to principle of the present invention and with together with the feature shown in other embodiment, implement.

Apparatus and method described here are exemplary.Apparatus and method of the present invention can comprise some or all features of device of example explanation and/or some or all steps of the method for example explanation.The step of method can with from here shown in the order different with described order carry out.Some embodiment can omit the step that exemplary method represents and introduces.Some embodiment can comprise that exemplary method does not have the step that represents and introduce.

Apparatus and method of the present invention are introduced in connection with the embodiment of example bone prosthetic device and feature and the hardware being associated and instrument.Introduce below with reference to the accompanying drawings device and the hardware being associated and instrument.It should be known that other embodiment also can adopt, and can carry out the variation of structure, function and processing procedure in the situation that not departing from the scope of the present invention with spirit.

Fig. 1 has represented the skeleton S of example.Skeleton S comprises example bone Si, and apparatus and method can be in this example bone Si in accordance with the principles of the present invention.Table 1 comprises the part list of bone Si.

Table 1: bone Si

Fig. 2 A has schematically illustrated the anatomical structure of bone B, and this bone B can be bone Si.The anatomical features of bone B is listed in table 2.Apparatus and method can relate to the one or more anatomical features shown in table 3 in accordance with the principles of the present invention.The feature of bone B can be with reference to axis of bone line LB(wherein, and B represents bone) and radius R B(is wherein, B represents bone) introduce.

Table 2: the anatomical features of some the bone types that can be treated by these apparatus and method.

Term " epiphysis portion " and " epiphysis portion fracture " can be for being illustrated in the fracture occurring in the epiphysis of long bone or metaphyseal region.Such fracture comprises periarticular and intra-articular fracture.

Fig. 2 B has represented the anatomical features of bone B.Bone B can be divided equally by plane 200 substantially.Plane 200 can comprise half space 205 and 207.Bone B can be divided equally by plane 202 substantially.Plane 202 can comprise half space 203 and 209.Half space 203,205,207 or 209 can be corresponding to the half space of dorsal part, front portion, rear portion, palmar, centre or sidepiece.Half space 203,205,207 or 209 title can represent based on bone B in skeleton S(Fig. 1) Zhong orientation.

Fig. 3 A has represented the anatomical features of fractured bones B.The view that reference block 300 represents bone B is substantially in front/rear plane 302.Half space MED and sidepiece half space LAT in the middle of front/rear plane 302 comprises.Centre/sidepiece plane 304 comprises palmar half space VOL and dorsal part half space DOR.

Bone B is expressed as radius, and this radius is in fractures Fh and Fa place fracture.Bone B is included in bone section Pb, Ph and the Pa at far-end D place.Bone section Pb is the largest portion of bone B.Bone section Ph is the head part of bone B.Bone section Ph and Pa comprise articular surface AS.Bone section Pa comprises a part of articular surface AS.Bone parts Pb, Ph and Pa be or local detachment separated with Fh along fractures Fa.Fractures Fa crosscut articular surface AS.The head part of fractures Fh crosscut bone B.

The bone B that comprises approximate longitudinal axes L B representing with cutaway view comprises cortical bone BCO and spongy bone BCA.Implantation piece is configured to the hole that enters that may locate at position H ' in the far-end D of bone B.Although H ' is expressed as, be arranged in bone B in the radial direction, H ' can be arranged in other direction of bone B, for example palmar, dorsal part, sidepiece, centre or rear direction.The configuration of implantation piece may need to remove spongy bone BCA.Example profiles C1 in spongy bone BCA, C2 and C3 are differently contoured, and in this profile, spongy bone BCA can remove.This profile of profile C4(C4 is the projection of profile C3 on articular surface AS) represented that profile C4 can be for example asymmetric.Profile C4 can have major axis A 1 and minor axis A2(to represent half).Other profile also can be asymmetric.

Here the apparatus and method that provide can represent and provide at position H ', locate enter hole H.At position H ', locate can pass Sui Nei space IS range ability XH through the device that enters hole H insertion, to arrive the head part of bone B.At position I ', locate can pass Sui Nei space IS range ability XI through the device that enters hole I insertion, to arrive the head part of bone B.The device of locating to insert at H ' may need " bending section ", to arrive the head part of bone B through Sui Nei space IS operation.The device of locating to insert at I ' may not need " bending section " to arrive the head part of bone B.Here the apparatus and method that provide can remove for example, spongy bone BCA in profile (C1, C2, C3).

Fig. 3 B has represented example implantation piece 300.Implantation piece 300 can implantable bone B in.Implantation piece 300 can be arranged to keep the reset of fractures Fa and Fh.

Implantation piece 300 can be positioned at the position of bone B inside.Implantation piece 300 can be positioned in the IS(Fig. 3 A of Sui Nei space and represent) in.Implantation piece 300 can insert through entering hole I.Implantation piece 300 can insert through entering hole H.

Implantation piece 300 can implantable bone (not shown) in.Implantation piece 300 along it longitudinal axes L I(wherein, I represents implantation piece) for elongated.Implantation piece 300 can comprise outside expansile mesh 306.Implantation piece 300 can comprise inner expansile mesh 308.Expansile mesh 306 can be expanded to certain radial distance from LI.Expansile mesh 308 can be expanded to certain radial distance from LI.

It is to insert or want the front end of the device in insertosome with respect to " nearside " common meaning that expansile mesh 306 can extend to distally hub 310(" distally " from proximal base 330).Expansile mesh 308 can extend to distally hub 320 from proximal base (not shown).

Expansile mesh 306 can comprise grid unit structure 322.Expansile mesh 308 can comprise grid unit structure 324.Grid unit structure 322 and/or 324 can be any suitable architecture, and can comprise the structure that different flexible regions are provided.

Grid unit 322 can be arranged to expand.Grid unit 324 can be arranged to expand.Grid unit 322 can expand by the expansion of expansile mesh 306.Grid unit 324 can expand by the expansion of expansile mesh 308.

Grid unit 322 can be configured to receive the anchoring piece of any appropriate, for example anchoring piece 326 or anchoring piece 329.Grid unit 324 can be configured to receive the anchoring piece of any appropriate, for example anchoring piece 326 or 329. Anchoring piece 326 and 329 can be arranged to penetrate expansile mesh 306 and/or expansile mesh 308. Anchoring piece 326 and 329 can penetrate in two or more positions expansile mesh 306 and/or expansile mesh 308.

When the inside of expansile mesh at bone, anchoring piece 326 or 329 can be arranged to bone section to be fixed in expansile mesh.

Implantation piece 300 can comprise parts 328.Parts 328 can be along axis LI longitudinal extension.Parts 328 can extend between distally hub 310 and nearside hub 330.

Fig. 4 has represented treatment scene 400.In scene 400, the fractures Fp place of using artificial traction technique in bone B re-establishes anatomical structure and resets.

In fracture repair, conventionally take temporarily or reset temporarily, to make bone section return to their normal position before their anchorings.

When the number dislocation less and/or bone section of bone section is little, can use sealing resetting technique.Sealing resets and does not comprise otch, and uses traction.Traction can be used different stretchings, compression and curvature movement, for re-establishing normal bone section location.

For the fracture situation of more displacements, can use the reset of limited opening.External probe, exclusive clamps or bone penetrating parts (for example line) can be used in interim reset.Can form less otch, thereby allow to help reorientate fracture segment with probe and folder.Open reduction can be carried out in surgical environment.

Line can comprise metal, polymer, fiber or other suitable material arbitrarily.Line can be k line.K line can be that diameter is in the scope from about 1mm to about 2mm.K line can slightly pointed and faceted tip, to facilitate by surgical drill, inserts in bone.K line can cross fractures and be urged to bone section from bone section, to make bone section remain on relative to each other appropriate location.K line can be located, and then strategically takes out, to reduce carrying out reset processing process with the mode of the interference of bone cavity preparation or implantation piece configuration.

K line can insert in bone section in the situation that surgical operation does not cut skin.K line can directly pierce in bone section through skin.Clinician can handle bone section by k line.Once bone section is in place, k line can also be for hold reset.

Fig. 5 has represented a part 500 for schematic surgical environment, and wherein, the fractures in bone B can utilize treatment technology diagnose and treat.Patient P can suitably take tranquilizer.Can apply limbs nerve block.Pressure sleeve (not shown) can be for making limbs Q remain on the relative state without blood.Limbs Q can support with any other suitable supporting member by processing platen 502, to control the position of bone B in surgical procedures.Environment 500 can comprise imaging system 504.Imaging system 504 can be electric magnetic image.Here the apparatus and method that provide can be carried out the without hindrance imaging of the fractures in bone B.Imaging system 504 can represent the position of the ray impermeable device of one or more bone sections, fixture, objective body, marker or any appropriate.

Fig. 6 has represented example treatment scene 600.In scene 600, with the resetting technique of Limited exposure, in the fractures Fh of bone B and Fa, re-establish anatomical structure and reset.K line 601 can cross fractures Fh holes.K line 601 can keep bone section Pa with respect to Gu DuanPb position.K line 603 can cross fractures Fa holes.K line can keep bone section Ph with respect to Gu DuanPb position.K line 603 can be holed at a certain angle, and this angle is substantially along any other suitable anatomical features of cartilage lower surface or the bone B of bone B.

K line 601 and 603 can cross fractures Fh and fractures Fa boring.K line 603 and 601 can keep bone section Pa and Ph with respect to Gu DuanPb position.Bone section Pb can be with reference to bone section.Bone section Pb can be backbone or the intermedium region of bone B.K line 601 and 603 can be so that bone section Pa and Ph locate with respect to bone section Pb temporarily.K line can be manipulated to and make bone section Ph and Pa be positioned at various treatment positions with respect to bone section Pb.

Fig. 7 has represented the example bone section 700 of bone B.Bone section Pb can be maximum bone section.Fractures (for example fractures Fh or fractures Fa, represent in Fig. 3 A) can allow bone section Pa or Ph to be moved into bone section Pb along anatomical structure, not align.Bone section Pb can be by bone section for referencial use, thereby processes for treatment, and one or more bone sections (for example Pa and Ph) can be with respect to locating with reference to bone section.

Fracture can allow bone section Ph along one or more quadrature-axis x1, y1He z1(center at O1 place) mobile.Fracture can allow bone section Ph to rotate around one or more axis (center is at O1 place).Fracture can allow bone section Pa along one or more quadrature-axis x2, y2He z2(center at O2 place) mobile.Fracture can allow bone section Pa to rotate around one or more axis (center is at O2 place).

Bone penetrating parts can be at position for example 709 places insert in bone section Ph.Bone penetrating parts can allow clinician make Ph edge or move around one or more axis x1, y1 and z1.Bone penetrating parts can be at position for example 711 places pierce in bone section Pa.Bone penetrating parts can allow clinician make Pa edge or move around one or more axis x2, y2 and z2.

Bone penetrating parts can be at one or more positions (for example 713 and 715) locates to insert in Pb.Bone penetrating parts can be anchored at device on bone section Pb.This device can keep one or two in Pa and Ph with respect to Gu DuanPb position.This device can be so that one or two in Pa and Ph moves with respect to bone section Pb.

Fig. 8 has represented example anatomical structure 800.Anatomical structure 800 comprises the posterior view of radius R and ulna U.Soft tissue S may reside in around radius R and ulna U.Radius R and ulna U are expressed as in basic palmar/dorsal part plane 304 (representing in Fig. 3 A).Radius R comprises fractures Fh.Fractures Fh can be so that bone section Bs be separated with radius R.Radius R can comprise that fractures Fa(represents in Fig. 3 A).Fractures Fa can be so that represent in the separated skeletonization section Pa of bone section Bs and Ph(Fig. 3 A).The movement of Bs can comprise that Bs moves to out-of-the way position with respect to radius R or ulna U.

Bone section Bs can normally be positioned at radius height Rh.Radius height Rh can measure according to the distance between the timberline L3 of institute and L4.Line L3 draws perpendicular to the longitudinal axis of radius R from processus styloideus radii.Line L4 draws perpendicular to the longitudinal axis of radius R from the articular surface of radius R.Normal radius height can be in the scope of 10-13mm.Radius height Rh can measure with respect to the anatomical features of ulna U.Bone section Bs can be positioned at abnormal radius At The Height.

Radius inclined angle alpha can be substantially in plane 302(Fig. 3 A, to represent) in, the inclination angle between articular surface As and transverse plane Pt.Transverse plane Pt is vertical with the projection L2 of the longitudinal axis of radius R.Typically not in fractured bone, α can be in the scope from about 7 ° to about 37 °.Apparatus and method can for example, for changing one or more bone sections α of (bone section Pa and Ph, represent in Fig. 3 A).

Fig. 9 has represented anatomical structure 900.Anatomical structure 900 has represented the side view of radius R and ulna U.Radius R and ulna U are expressed as and substantially in centre/sidepiece plane 302(Fig. 3 A, are representing) in.Palmar inclination angle λ represents substantially in plane 304(Fig. 3 A) in, at articular surface As and transverse plane Pt(, be expressed as in the position different from the position shown in Fig. 8) between inclination angle.(palmar inclination angle can be provided by the complementary angle of λ, is expressed as in the drawings δ, the angle between articular surface As and the longitudinal axes L R of radius.) apparatus and method can for example, for changing one or more bone sections λ of (bone section Pa and Ph, represent in Fig. 3 A).

Figure 10 has represented example fixture 1000.Bone piercing elements 1001 can pierce in bone B(Fig. 2 A and represent) in.Bone piercing elements 1001 can be k line.Bone piercing elements 1001 can be positioned in bone B with respect to anatomical structure sign.Bone piercing elements 1001 can be inserted the back surface of bone B.

Fixture 1000 can comprise bridging element 1005.Bridging element 1005 can comprise receptor 1003.Receptor 1003 can be configured to receive bone piercing elements 1001.Receptor 1003 can be configured to receive bone piercing elements 1007.Bridging element 1005 can so that bone piercing elements 1001 with respect to bone piercing elements 1007 location.

Bone piercing elements 1001 can be inserted in bone section, for example, in bone section Ph(Fig. 3 A, represent).Bone piercing elements 1003 can be inserted in bone section, for example, in bone section Pa(Fig. 7, represent).Bridging element 1005 can move into location bone section Ph and Pa.For example, bridging element 1005 can move into and change radius inclined angle alpha (representing in Fig. 8).Clinician can handle bone piercing elements 1001, to bone section Ph is represented in initial point O1(Fig. 7) motion, and no matter represent in the 709(Fig. 7 of position) whether overlap with initial point O1.Clinician can handle bone piercing elements 1007, to bone section Pa is represented in initial point O2(Fig. 7) motion, and no matter represent in the 711(Fig. 7 of position) whether overlap with initial point O2.

Bridging component 1005 can comprise pressure distribution parts 1013.Pressure distribution parts 1013 can slide in conduit 1015.In primary importance, pressure distribution parts 1013 can allow the bone piercing elements of being located by bridging component 1005 in the interior motion of receptor 1003.In primary importance, bone piercing elements 1001 can be moved and rotate around axis L1001 along axis L1001.In primary importance, bone piercing elements 1007 can be moved and rotate around axis L1007 along axis L1007. Bone piercing elements 1001 and 1007 motion can cause respectively that bone section Ph and Pa are around the motion of axes O 1 and O2.

In the second position, pressure distribution parts 1013 can be exerted pressure in bone piercing elements, and substantially prevent the motion of bone piercing elements.

Pressure can be applied in bone piercing elements by narrowing down at least partly of receptor 1003.In the second position, pressure distribution parts 1013 can be arranged so that part receptor 1003, that cross pressure distribution parts 1013 narrows down.

In the second position, pressure distribution parts 1013 can prevent any bone piercing elements of being received by receptor 1003 with respect to bridging component 1005 motions and prevent bone section Ph and Pa with respect to the corresponding sports of initial point O1 and O2.

Pressure distribution parts 1013 can be used hold-down screw 1017 and be arranged on primary importance or the second position.The rotation of hold-down screw 1017 can be so that pressure distribution parts 1013 slide in conduit 1015.

Fixture 1000 can comprise base portion 1019.The motion of base portion 1019 can so that bone piercing elements 1001 with respect to bone piercing elements 1007 location.The motion of base portion 1019 can so that bridging element 1005 around axis L1001 pivotable.The motion of base portion 1019 can so that bridging element 1005 around axis L1007 pivotable.The motion of base portion 1019 can be so that bridging element 1005 rotating in rear/frontal plane substantially.The motion of base portion 1019 can change radius inclined angle alpha (representing in Fig. 8).

Base portion 1019 can comprise the axle collar 1021.The axle collar 1021 can comprise receptor 1025.Receptor 1025 can be configured to receive bone piercing elements 1023.Bone piercing elements 1023 can be inserted in bone section Pb (representing in Fig. 7).

Bone piercing elements 1023 can be in the interior motion of the axle collar 1021.Bone piercing elements 1023 can be along axis L1023 translation.Bone piercing elements 1023 can be rotated around axis L1023.Bone piercing elements 1023 can be used hold-down screw 1027 and be fixed on the axle collar 1021.In primary importance, hold-down screw 1027 can allow bone piercing elements 1023 in the interior freely-movable of the axle collar 1021.In the second position, hold-down screw 1027 can limit bone piercing elements 1023 in the interior motion of the axle collar 1021.In the second position, hold-down screw 1027 can so that pressure distribution to bone piercing elements 1023.Pressure can distribute with respect to the axle collar 1021.The rotation of hold-down screw 1027 can discharge or exert pressure to bone piercing elements 1023.

By suitable use hold-down screw 1027, base portion 1019 can move and locks in place up or down along bone penetrating parts 1023, to make bridging component 1005 rotations and therefore regulate and locking palmar inclination angle λ (representing in Fig. 9).

The axle collar 1021 can be along axis L1019 translation.Base portion 1019 can comprise conduit 1033 and 1035, to allow the axle collar 1021 motions.The rotation of hold-down screw 1029 can so that the axle collar 1021 along axis L1019 translation.Hold-down screw 1029 can limit the axle collar 1021 along axis L1019 translation.Hold-down screw 1029 can comprise receptor 1031.Receptor 1031 can be configured to receive bone piercing elements.The bone piercing elements being received by receptor 1031 can arrange along axis L1019 the position of the axle collar 1021.The axle collar 1021 can be corresponding to representing in radius height Rh(Fig. 8 with respect to the position of bridging component 1005).

Supporting member 1009 can be so that base portion 1019 be connected with bridging component 1005.The motion of base portion 1019 can so that bone piercing elements 1023 with respect to bone piercing elements 1001 and 1007 location.The motion of base portion 1019 can be so that represent in bone section Ph or Pa(Fig. 7) in initial point O1 and O2(Fig. 7, represent respectively) motion.The motion of base portion 1019 can so that bone section Ph and Pa with respect to representing in bone section Pb(Fig. 7) location.

Supporting member 1009 can comprise receptor 1011.Receptor 1011 can receive bone piercing elements.Receptor 1011 can be configured to receive to pierce in bone B(Fig. 2 A and represent) near anatomical structure in bone piercing elements.For example,, when bone B represents in radius R(Fig. 8) time, receptor 1011 can receive to pierce in ulna U(Fig. 8 and represent) in bone piercing elements.

Figure 11 has represented general frame 1100.Framework 1100 can have with fixture 1000(Figure 10 in represent) common one or more features.Framework 1100 can comprise bridging component 1005.The projection 1107 of example can be for making bridging component 1005 align with anatomical structure sign.Framework 1100 can comprise base portion 1019.Framework 1100 can comprise receptor 1101 and 1102. Receptor 1101 and 1102 can be configured to receive in bone piercing elements 1001 and 1007(Figure 10 and represent). Bone piercing elements 1001 and 1007 can be inserted in bone section Ph and Pa(Fig. 3 A and represent) in.

Receptor 1101 and 1102 can limit line Ray1.Receptor 1101 and 1102 can represent in comprising axis LB(Fig. 3 A) planar separation.Plane can be to represent in plane 200(Fig. 2 B).Plane can be to represent in plane 202(Fig. 2 B).Receptor 1101 and 1102 can receive to penetrate in bone B(Fig. 2 A and represent) the bone piercing elements of half space.This half space can be to represent in half space 203,205,207 or 209(Fig. 2 B).

The bone piercing elements being received by receptor 1101 can be inserted in bone B(Fig. 2 A and represent) bone section in.Bone section may reside in the half space that comprises receptor 1101.The bone piercing elements being received by receptor 1102 can be inserted in the bone section of bone B.Bone section may reside in the half space that comprises receptor 1102.

Receptor 1103 can be configured to receive in bone piercing elements 1023(Figure 10 and represent).Receptor 1103 can be arranged to bone piercing elements 1023 to introduce in bone B(Fig. 2 A and represent) in.Bone piercing elements 1023 can pierce in bone section Pb(Fig. 3 A and represent) in.Receptor 1103 can represent basic the introducing in plane 200(Fig. 2 B of bone piercing elements 1023) in.Plane 200 can be divided bone B equally.Plane 200 can limit in half space 207 and 205(Fig. 2 B and represent).Receptor 1103 can be substantially along representing in plane 202(Fig. 2 B) guiding bone piercing elements.Plane 202 can be divided bone B equally.Plane 202 can limit in half space 203 and 209(Fig. 2 B and represent).

Receptor 1103 and receptor 1101 can limit line Ray2.Ray1 and Ray2 can angulation ρ.Angle ρ can follow closely 1029 by rotary fixing screw and regulate.The rotation of hold-down screw 1029 can be corresponding to receptor 1103 moving along LB projection.The rotation of hold-down screw 1029 can represent in bone piercing elements 1001,1007 and 1023(Figure 10) exert pressure.Pressure can so that bone section Ph and Pa with respect to representing in bone section Pb(Fig. 3 A) motion.

Angle ρ can arrange through receptor 1031 by bone piercing elements.Angle ρ can represent with radius height Rh(Fig. 8) corresponding.Ray1 and Ray2 can select according to the anatomical features of bone.

Angle θ can be formed between Ray1 and the projection of axis LB.Angle θ can be chosen as corresponding with radius inclined angle alpha (representing in Fig. 8).Angle θ can be chosen as corresponding with palmar inclination angle λ (representing in Fig. 9).Angle θ can regulate by swing bridge relay part 1005.Angle θ can be by making bone piercing elements 1023 for example, arrange through receptor 1103 and bone section (bone section Pb, represents in Fig. 7).

Bridging component 1005, supporting member 1009 and base portion 1019 can limit recess 1105.Recess 1105 can be so that unhinderedly enter shown in bone B(Fig. 2 A).Recess 1105 can conveniently be used in imaging system 504(Fig. 5 and represent) come to represent in imaging bone section Pb, Ph and Pa(Fig. 3 A).

Figure 12 A has represented example treatment scene 1200.Bone section Bs is separated with radius R.Separation can be due to fractures, for example, in fractures Fh or fractures Fa(Fig. 3 A, represent).For example install and represent in fixture 1000(Figure 10) or general frame 1100(Figure 11 in represent) can be for bone section Bs be located with respect to radius R.Radius R can have longitudinal axes L R.Clinician can be so that bone section Bs locates with respect to radius R treatment.For example, clinician can regulate palmar inclination angle λ (representing in Fig. 9).

Bone piercing elements 1001 can be fixed on bridging component 1005 by hold-down screw 1017 and pressure distribution parts 1013.Bone penetrating parts 1001 can pierce in bone section Bs.Bone penetrating parts 1001 can be for handling bone section Bs around the position at Gu Duan Bs center.

Bridging component 1005 can be fixed on base portion 1019 by supporting member 1009.Bone penetrating parts 1023 can be by representing in receptor 1025(Figure 10) pass base portion 1019 and the axle collar 1021.Bone penetrating parts 1023 can pass in radius R.Bridging component 1005 can be by making base portion 1019 rotate along axis L1023 translation.Base portion 1019 can be by the axle collar 1021 and hold-down screw 1029 and is substantially prevented the translation along axis L1019.

Make base portion 1019 along axis L1023 translation and make bridging component 1005 rotation can be so that bone section Bs rotation.The rotation of bone section Bs can adjusting angle γ.Angle γ can be adjusted to corresponding with palmar inclination angle λ.Angle γ can arrange with hold-down screw 1027.Hold-down screw 1027 can prevent that base portion 1019 from moving along axis L1023 substantially.

Figure 12 B has represented pressure distribution parts 1013.Pressure distribution parts 1013 can comprise one or more through holes, for example 1252.Each through hole can represent with a receptor 1003(Figure 10 and 11) corresponding.Through hole 1252 be for bone penetrating parts for example 1001 and 1007(Figure 10 represent) through hole.Through hole 1252 can comprise wide end 1254 and narrow end 1256.Through hole 1252 can have length l, and this length l can be greater than the diameter of corresponding receiver.Pressure distribution parts 1013 can be guided and longitudinal sliding motion by conduit 1258 and 1260.Brake surfaces 1262 and 1264 can be interfered and be limited lengthwise movement by the brake (not shown) with from bridging component 1005, and this bridging component 1005 is positioned in guide channel.

During in bone penetrating parts is inserted receptor 1003 or in the interior adjusting of receptor 1003, wide end 1254 aligns with receptor.When bone penetrating parts locks, pressure distribution parts 1013 move, so that narrow end 1256 aligns with receptor.Narrow end 1256 can be enough narrow, to exert pressure to bone penetrating parts, thereby keeps bone penetrating parts with respect to bridging component 1005.

Figure 12 C has represented the pressure distribution parts 1013 in bridging component 1005. Bone penetrating parts 1001 and 1007 is passed in the through hole in pressure distribution parts 1013.Through hole 1252 also be can't help pressure distribution parts and is used.Brake surfaces 1264 is against brake 2180.Brake surfaces 1262 is removed from brake 2182.Therefore, pressure distribution parts 1013 are in unlocking structure.Hold-down screw 1017 is fixed on (outside the plane of accompanying drawing) on pressure distribution parts 1013, thereby hold-down screw 1017 can make pressure distribution parts 1013 move, and producing pressure, this pressure passes to any bone joint elements that may be present in bridging component 1005 by pressure distribution parts 1013 substantially simultaneously.

The projection 1107 of example can be for making bridging component 1005 align with anatomical structure sign.

Figure 12 B has represented the pressure distribution parts 1013 in bridging component 1005. Bone penetrating parts 1001 and 1007 is passed in the through hole in pressure distribution parts 1013.Through hole 1252 also be can't help pressure distribution parts and is used.Brake surfaces 1264 is against brake 2180.Brake surfaces 1262 is removed from brake 2182.Therefore, pressure distribution parts 1013 are in unlocking structure.Hold-down screw 1017 is fixed on (outside the plane of accompanying drawing) on pressure distribution parts 1013, thereby hold-down screw 1017 can make pressure distribution parts 1013 move, and producing pressure, this pressure passes to any bone joint elements that may be present in bridging component 1005 by pressure distribution parts 1013 substantially simultaneously.

Figure 13 has represented example fixture 1300.Fixture 1300 can comprise the first osteocomma manipulator 1312.The first osteocomma manipulator 1312 can comprise bone penetrating parts 1315.Bone penetrating parts 1315 can be fixed in bone section, for example, in bone section Pa or bone section Ph(Fig. 3 A, represent).The first osteocomma manipulator 1312 can comprise pipe 1317.Pipe 1317 can comprise receptor 1326.Receptor 1326 can receive bone penetrating parts 1315.

In the time of on being fixed on bone, bone penetrating parts 1315 can be so that bone section moves along axis X, Y and Z.In the time of on being fixed on bone section, bone penetrating parts 1315 can so that bone section around axis X, Y and Z rotation.The movement of bone section or rotation can be moved or rotate by the initial point around bone section corresponding to bone section.The movement of bone section or rotation can so that bone section with respect to for example, being positioned at suitable treatment position with reference to bone section (Pb represents in Fig. 3 A).

The first osteocomma manipulator 1312 can comprise collar receiver part 1325.Collar receiver part 1325 can be arranged in translation in plane X-Y.Pipe 1317 can comprise hinged surperficial 1319.Hinged surperficial 1319 can allow bone penetrating parts 1315 move and rotate around axis X, Y and Z.Hinged surperficial 1319 can be hinged with respect to collar receiver part 1325.

Pipe 1317 can rotate around axis Z.Pipe 1317 can comprise external screw thread 1327.Pipe 1317 can be threadedly engaged with interior threaded part 1318.Interior threaded part 1318 can comprise hinged surperficial 1319.Pipe 1317 be threadedly engaged with and can move with respect to interior threaded part 1318 so that manage 1317.Pipe 1317 and being threadedly engaged with of interior threaded part 1318 can apply or be released in the pressure in bone penetrating parts 1315.Pipe 1317 and interior threaded part 1318 be threadedly engaged with the pressure that can apply or be released on hinged surperficial 1319.Pipe 1317 and being threadedly engaged with of interior threaded part 1318 can apply or be released in the pressure on collar receiver part 1325.Pipe 1317 and being threadedly engaged with of interior threaded part 1318 can apply or be released in the pressure on framework 1323.Framework 1323 can comprise frame cover 1324.

Be applied to substantially fixedly Gai Guduan position of pressure on bone penetrating parts 1315, hinged surperficial 1319, collar receiver part 1325 and framework 1323, this bone section is fixed in bone penetrating parts 1315.

Fixture 1300 can comprise the second osteocomma manipulator 1314.The second osteocomma manipulator 1314 can have the one or more features common with the first osteocomma manipulator 1312.For example, the second osteocomma manipulator can comprise bone penetrating parts 1313, manages 1329, screw thread 1335, hinged surperficial 1333, collar receiver part 1331 and interior threaded part 1332.

The second osteocomma manipulator 1314 can for example, so that the second bone section (bone section Pa or Ph) be mobile or rotation.The second osteocomma manipulator 1314 is Gai Guduan position substantially fixedly, and this bone section is fixed in bone penetrating parts 1313.The second osteocomma manipulator 1314 can so that the second bone section with respect to the first bone section, locate.

Fixture 1300 can comprise base portion 1301.Base portion 1301 can comprise slider 1305.Slider 1305 can slide along axis L1301 in conduit 1303.Hold-down screw 1307 can arrange slider 1305 along the position of axis L1301.Slider 1305 can comprise receptor 1321.Receptor 1321 can receive bone penetrating parts 1311.Bone penetrating parts can have with bone penetrating parts 1001,1007 or 1023(Figure 10 in represent) common one or more features.

Bone penetrating parts 1311 for example can be fixed on, with reference in bone section (bone section Pb represents in Fig. 3 A).Slider 1305 and base portion 1301 can rotate around axis L1311.Around axis L1311 rotation can so that the first and second bone sections with respect to locating with reference to bone section.Around the position of axis L1311, can follow closely 1309 and substantially fixing by rotary fixing screw.The rotation of hold-down screw 1309 can apply or be released in the pressure in penetrating parts 1311.

Slider 1305 and base portion 1301 can be along axis L1311 translations.Along axis L1311 translation can so that the first and second bone sections with respect to locating with reference to bone section.For example, along axis L1311 translation, the first and second bone sections can be positioned to palmar inclination angle (representing in Fig. 9) or radius inclination angle (representing in Fig. 8).Slider 1305 can be followed closely 1309 along axis L1311 by rotary fixing screw with respect to the position of base portion 1301 and arrange.The rotation of hold-down screw 1309 can be exerted pressure or release pressure to base portion 1301.

Base portion 1301 can be along axis L1301 translation.Along axis L1301 translation can so that the first and second bone sections with respect to locating with reference to bone section.For example, along axis L1301 translation, the first and second bone sections can be positioned to radius At The Height (representing in Fig. 8).Base portion 1301 can be followed closely 1307 by rotary fixing screw along the position of axis L1301 and arrange.The rotation of hold-down screw 1307 can apply or be released in the pressure on base portion 1301.Slider 1305 can arrange by bone penetrating parts (not shown) being fixed on reference to bone (by receptor 1321) is upper with respect to the position of base portion 1301.

Figure 14 has represented osteocomma manipulator 1400.Osteocomma manipulator 1312 or osteocomma manipulator 1314 can have the one or more features common with osteocomma manipulator 1400.Osteocomma manipulator comprises the axle collar 1401 and bone penetrating parts 1315.The axle collar 1401 comprises pipe 1317.Pipe 1317 can comprise for receiving the sleeve pipe of bone penetrating parts 1403.Sleeve pipe can have with receptor 1326(Figure 13 in represent) common one or more features.Pipe 1317 comprises external screw thread 1327.Screw thread 1327 can engage with interior threaded part 1318.Interior threaded part 1318 can comprise hinged surperficial 1319.Hinged surperficial 1319 can comprise basic spherical shape part.

The axle collar 1401 can comprise convergent shape part 1405.Convergent shape part 1405 can comprise hinged surperficial 1411.Hinged surperficial 1411 can comprise basic spherical shape part.The joint of pipe 1317 and convergent shape part 1405 can apply or be released in the pressure keeping in finger 1413, and finger is for example similar to cartridge clip.Be applied to the pressure that keeps in finger 1413 position of bone fixation penetrating parts 1315 substantially.Be applied to the pressure that keeps in finger 1413 substantially bone fixation penetrating parts 1315 along axis Z or around the position of axis Z.

Hinged surperficial 1411 and 1319 can provide the freedom of motion of the axle collar 1401 with respect to collar receiver part 1325.Hinged surperficial 1411 and 1319 can allow freely translation of the axle collar 1401 and rotate around axis X, Y and Z.The hinged surperficial 1411 and 1319 bone sections that can conveniently be fixed on osteocomma manipulator 1400 are moved along three quadrature-axis with around three quadrature-axis.

Figure 15 has represented exemplary components 1500.Parts 1500 can comprise pipe 1317, and this pipe 1317 is threadedly engaged with interior threaded part 1318.Parts 1500 can comprise maintenance finger 1413.Being threadedly engaged with of pipe 1317 and interior threaded part 1318 can represent keeping finger 1413 to introduce in convergent shape part 1405(Figure 14) in.Pipe 1317 and being threadedly engaged with of interior threaded part 1318 can be so that interior threaded part 1318 move with respect to convergent shape part 1411.

Figure 16 has represented pipe 1600.Pipe 1600 can comprise one or more features of pipe 1317.Pipe 1600 can comprise sleeve pipe 1601.Sleeve pipe 1601 can be configured to receive bone penetrating parts 1315.

Pipe 1600 can comprise maintenance finger 1413.Keep finger 1413 to be associated with the first radius r 1.Radius r 1 can be measured with respect to longitudinal axes L 1601, and this longitudinal axes L 1601 is through the center of sleeve pipe 1601.Keep finger 1413 to be associated with the second radius r 2.Radius r 2 can be measured with respect to the center of sleeve pipe 1601.

Radius r 1 and r2 can limit and the taper that keeps finger 1413 to be associated.In convergent shape part 1405(Figure 14, represent) can be arranged to keeping finger 1413 to exert pressure.Pressure can compress maintenance finger 1413 against the bone penetrating parts of inserting in sleeve pipe 1601.

Figure 17 has represented exemplary components 1700.Parts 1700 can comprise pipe 1317 and convergent shape part 1405.Convergent shape part 1405 can be configured to receive and keep finger 1413.Convergent shape part 1405 can comprise surface 1701.

Figure 18 represents in convergent shape part 1405 18-18(Figure 17 along the line) view.Convergent shape part 1405 can comprise sleeve pipe 1801.In sleeve pipe 1801 and sleeve pipe 1601(Figure 16, represent) can be concentric.Sleeve pipe 1801 can comprise radius r 3.The value of radius r 3 can be less than in radius r 2(Figure 16 and represent).Radius r 3 can form brake 1803.Brake 1803 can be arranged to compression and keep finger 1413.

Radius r 3 and r4 can limit taper.The taper being limited with r4 by radius r 3 can be corresponding with the taper being limited by radius r 1 and r2.The taper being limited by radius r 3 and r4 can be arranged to compression and keep finger 1413.

Figure 19 has represented exemplary components 1900.Parts 1900 can represent the feature of the fixture 1300 sealed by framework 1323.

Collar receiver part 1325 can comprise upper board 1905 and lower panel 1901.Hinged surperficial 1319 can be arranged to against upper board 1905 hinged.In hinged surperficial 1411(Figure 14, represent) can be arranged to against lower panel 1901 hinged.Against upper board 1905 and lower panel 1901 hinged can allow osteocomma manipulator 1312 around with along axis X, Y and Z, move.

Upper board 1905 can be removed from lower panel 1901.Upper board 1905 can be subject to representing framework 1323(Figure 13 from removing of lower panel 1901) restriction.Upper board 1905 is removed and can be exerted pressure to framework 1323 from lower panel 1901 against framework 1323.

Collar receiver part 1331 can comprise upper board 1907 and lower panel 1903.Upper board 1907 and lower panel 1903 can have respectively and upper board 1905 and the common one or more features of lower panel 1901.Osteocomma manipulator 1314 can have the one or more features common with osteocomma manipulator 1312.

Figure 20 has represented to represent in 20-20(Figure 13 along the line) illustrated section 2000.External screw thread 1327 can engage with interior threaded part 1318.Pipe 1317 and interior threaded part 1318 be threadedly engaged with can so that interior threaded part 1318 from convergent shape part 1405, remove.Pipe 1317 and being threadedly engaged with of interior threaded part 1318 can be moved with respect to interior threaded part 1318 so that manage 1317.Being threadedly engaged with of pipe 1317 and interior threaded part 1318 can will keep finger 1413 to introduce in convergent shape part 1405.

In convergent shape part 1405, in brake 1803 and sleeve pipe 1801(Figure 18, represent) can will keep finger 1413 to be pressed against in bone penetrating parts 1315.Keep finger 1413 to be pressed against in bone penetrating parts 1315 and can substantially prevent that bone penetrating parts 1315 is in pipe 1317 interior motions.

The compression of maintenance finger 1413 can be subject to the restriction of bone penetrating parts 1315.The expansion of maintenance finger 1413 can be subject to the restriction of brake 1803 and sleeve pipe 1801.The restriction being applied by bone penetrating parts 1315, brake 1803 and sleeve pipe 1801 can so that interior threaded part 1318 from convergent shape part 1405, remove.Interior threaded part 1318 from convergent shape part 1405 remove can so that upper board 1905 from lower panel 1901, remove.Upper board 1905 is removed the restriction that can be subject to framework 1323 from lower panel 1901.

Interior threaded part 1318 removes from convergent shape part 1405 that remove from lower panel 1901 with upper board 1905 can be at the interior generation pressure of framework 1323.Pressure in framework 1323 can stationary pipes 1317 with respect to the position of collar receiver part 1325.Pressure in framework 1323 can fixed axis ring bearing part 1325 with respect to representing in framework 1323(Figure 13) position.Pressure in framework 1323 can prevent 1312 motions of bone manipulator substantially.Pressure in framework 1323 can bone fixation manipulator 1312 position.Pressure in framework 1323 can bone fixation Duan position, and this bone section is fixed on bone manipulator 1312.

Figure 21 has represented exemplary components 2100.Parts 2100 can comprise the axle collar 2101.The axle collar 2101 can comprise pipe 2102.Pipe 2102 can comprise external screw thread 2103.The axle collar 2101 can comprise interior threaded part 2107.The axle collar 2101 can comprise receptor 2105.Receptor 2105 can be configured to receive bone penetrating parts, for example, in bone penetrating parts 1315(Figure 13, represent).Bone penetrating parts can be along axis Z translation.Bone penetrating parts can be rotated around axis Z.Bone penetrating parts can be fixed in bone section, for example, in bone section Pa or Ph(Fig. 3 A, represent).

The axle collar 2101 can comprise convergent shape part 2114.Convergent shape part 2114 can comprise swelling part 2115.Swelling part can be arranged to engage with collar receiver part 2109.The joint of swelling part 2115 and collar receiver part 2109 fixedly the axle collar 2101 with respect to the position of collar receiver part 2109.The joint of swelling part 2115 and collar receiver part 2109 can bone fixation penetrating parts with respect to the position of collar receiver part 2109.The joint of swelling part 2115 and collar receiver part 2109 can bone fixation section with respect to the position of collar receiver part 2109.

Swelling part 2115 can limit basic spherical shape.The axle collar 2101 can be arranged to along axis X, Y or Z translation.The axle collar 2101 can be arranged to around axis X, Y or Z rotation.

Collar receiver part 2109 can be arranged to the translation along axis Y.Collar receiver part 2109 can be arranged to along axis X translation.Hold-down screw (for example hold-down screw 1307, represent in Figure 13) can insert in conduit 2113.Collar receiver part 2109 can be arranged to around hold-down screw pivotable.Hold-down screw can be threadedly engaged with base portion (not shown).Base portion can be fixed on reference in bone section, for example, in bone section Pb(Fig. 3 A, represent).Hold-down screw and base portion be threadedly engaged with can fixed axis ring bearing part 2109 in plane X-Y Zhong position.

Collar receiver part 2109 in plane X-Y, locate can so that the bone section being fixed on collar receiver part 2109 with respect to base portion, locate.Collar receiver part 2109 is located in plane X-Y can be so that be fixed on bone section on collar receiver part 2109 with respect to the reference bone section location being fixed on base portion.Fixed axis ring bearing part 2109 can make to represent in fractures Fa in bone B or Fh(Fig. 3 A with respect to the position of base portion) reset.

Figure 22 has represented the pipe 2200 of example.Pipe 2200 can comprise external screw thread 2103.Pipe 2200 can comprise maintenance finger 2201.Keep finger 2101 can comprise radius r 7.Radius r 7 can be measured with respect to longitudinal axes L 2203, and this longitudinal axes L 2203 is through the center of sleeve pipe 2203.Keep finger 2201 can comprise radius r 6.Radius r 6 can be measured with respect to the center of sleeve pipe 2203.Radius r 6 and r7 can limit and the taper that keeps finger 2201 to be associated.

Pipe 2200 can comprise otch 2205.Otch 2205 finger 2201 that can allow to expand is compressed around axis L2203.In convergent shape part 2114(Figure 21, represent) can be arranged to along the taper being limited by r6 and r7 to keeping finger 2101 to exert pressure.Pressure can compress and keep finger 2101.Pressure can will keep finger 2101 to be pressed against in the bone penetrating parts of inserting in sleeve pipe 2203.

Figure 23 has represented to represent in parts 2100 23-23(Figure 21 along the line) cutaway view.Being threadedly engaged with of external screw thread 2103 and interior threaded part 2107 can will keep finger 2201 to introduce in convergent shape part 2114.Convergent shape part 2114 can comprise swelling part 2115.Convergent shape part can comprise radius r 8.Convergent shape part can comprise radius r 9.Radius r 8 and r9 define taper.The taper being limited by radius r 8 and r9 can be arranged to respond external screw thread 2103 and being threadedly engaged with of interior threaded part 2107 and keep finger 2201 around axis L2203 compression.

Around axis L2203 compression, keep finger 2201 to exert pressure to the bone penetrating parts of inserting in sleeve pipe 2203.Keep the compression of finger 2201 to be limited by bone penetrating parts.

Can be so that swelling part 2115 expands against collar receiver part 2109 by the pressure that keeps finger 2201 to be applied to the pressure in bone penetrating parts and to be applied in convergent shape part 2114 by maintenance finger 2201.The expansion of swelling part 2115 can be limited by collar receiver part 2109.Pressure on bone penetrating parts and collar receiver part 2109 is the position of the axle collar 2101 substantially fixedly.Pressure on bone penetrating parts and collar receiver part 2101 is the position of bone fixation penetrating parts substantially.Pressure on bone penetrating parts and collar receiver part 2101 can substantially fixedly be fixed on the Gu Duan position in bone penetrating parts.

Figure 24 has represented the example axle collar 2400.The axle collar 2400 can comprise in axle collar 2101(Figure 21 and representing) one or more features.The axle collar 2400 can comprise brake 2401.Brake 2401 can be fixed on swelling part 2115.Brake 2401 can be arranged to stop the motion of convergent shape part 2114.

Figure 25 has represented exemplary components 2500.Parts 2500 can comprise interior threaded part 2107, convergent shape part 2114, swelling part 2115 and collar receiver part 2109.Swelling part 2115 can comprise brake 2401.Collar receiver part 2109 can comprise shell 2501.Shell 2501 can be arranged to limit 2114 motions with respect to collar receiver part 2109 of convergent shape part.

The constrained motion of convergent shape part 2114 can conveniently respond pipe 2102 and being threadedly engaged with of interior threaded part 2107 and pressure in release shaft ring bearing part 2109.The constrained motion of convergent shape part 2114 can conveniently respond pipe 2102 and being threadedly engaged with of interior threaded part 2107 and be applied to the pressure in collar receiver part 2109.

Figure 26 has represented the treatment scene 2600 of example.Osteocomma manipulator 1312 can be fixed on bone section Ph.Osteocomma manipulator can be located bone section Ph along three quadrature-axis.Osteocomma manipulator 1312 can be by making bone section Ph rotate to locate bone section Ph around three quadrature-axis.Three quadrature-axis can originate from the initial point (representing in Fig. 7) of bone section Ph.Bone section Ph can locate with respect to bone section Pa.Bone section Ph can be with respect to locating with reference to bone section Pb.Osteocomma manipulator 1312 can lock bone section Ph with respect to another Gu Duan position.

Osteocomma manipulator 1314 can be fixed on bone section Pa.Osteocomma manipulator can be along three quadrature-axis location bone section Pa.Osteocomma manipulator 1314 can be around three quadrature-axis rotation bone section Pa.Three quadrature-axis can originate from the initial point (representing in Fig. 7) of bone section Pa.Bone section Pa can locate with respect to bone section Ph.Bone section Pa can be with respect to locating with reference to bone section Pb.Osteocomma manipulator 1314 can lock bone section Pa with respect to another Gu Duan position.

Slider 1305 can so that bone section Pa and Ph with respect to locating with reference to bone section Pb.Bone penetrating parts 2601 can be inserted in receptor 1321(Figure 13 and represent) neutralization be fixed on Pb.Slider 1305 can be followed closely 1309 and 1307 by rotary fixing screw along the position of bone penetrating parts 1311 and 2601 and lock.

Hold-down screw 1307 can be exerted pressure to base portion 1301.Hold-down screw 1307 can be by being pressed against slider 1305 and slider bottom 2603 on base portion 1301 and exerting pressure.Pressure is the position of slider 1305 and slider bottom 2603 substantially fixedly.Pressure substantially fixed base 1301 with respect to Pb position.Pressure substantially bone fixation section Pa and Ph with respect to Pb position.

Bone section Pa, Ph and Pb can be locked in mutual treatment distance.Locking bone section Ph, PaHePb position can the Fh of reseting fracture portion and Fa.

Figure 27 has represented the clinical procedure 2700 of example.Clinical procedure 2700 can comprise bone penetrating parts 2701 is pierced in bone section Bs.Bone section Bs can be due to fractures F with separated with reference to bone section Pb.Bone penetrating parts 2701 can pierce in the position on bone section Bs.This position can be determined according to the anatomical features of bone section Bs.This position can be determined according to the target site of bone B inside.Target site can with insert bone B in so that the target location of the implantation piece of repair of fractures F is corresponding.This position can be according to determining at bone B Shang position H ' or I '.

Figure 28 has represented exemplary device 2800.Device 2800 can comprise pin 2815.Pin 2815 can have the one or more features common with bone penetrating parts 2701.Device 2800 can comprise supporting member 2801.Supporting member 2801 can comprise extension 2805, extension 2817 and extension 2807.Extension 2817 can regulate with hold-down screw 2819 and receptor 2811,2813 with respect to the structure of extension 2805 and 2807.

Supporting member 2801 can be arranged to hinged with respect to pin 2815.Supporting member 2801 can comprise concave surface 2809.Supporting member 2801 can comprise concave surface 2821.Concave surface 2809 can be arranged to against pin 2815 hinged, and concave surface 2821 can be arranged to against pin 2815 hinged.

In bone B(Figure 27, represent) can be radius.When bone B represents in skeleton S(Fig. 1) during the radius on right side, concave surface 2809 can be arranged to against pin 2815 hinged.When bone B is the radius in skeleton S left side, concave surface 2821 can be arranged to against pin 2815 hinged.

Supporting member 2801 can comprise indicator 2803.Supporting member 2801 can be from the first anatomical structure direction of bone B across the second anatomical structure direction to bone B.The first anatomical structure direction can be shown in Figure 27 at bone B(with pin 2815) Shang position is corresponding. Concave surface 2809 or 2821 can be positioned at the first anatomical structure direction.Indicator 2803 can be positioned at the second anatomical structure direction.When bone B is radius, supporting member 2801 can from the dorsal part direction (representing Fig. 3 A) of bone B across the third side to bone B to (representing in Fig. 3 A).

Concave surface 2809 or 2821 can be positioned at indicator 2803 near the anatomical structure direction of bone B against pin 2815 is hinged.In near the position anatomical structure direction of bone B, indicator 2803 can be pointed to the inlet point on bone B.

Inlet point can be corresponding to H ’Huo position, position I ' (representing in Fig. 3 A).Inlet point can be based on bone B inside target site.Target site can be corresponding with the target location of implantation piece of being arranged to repair of fractures F.

Figure 29 has represented the treatment scene 2900 of example.In scene 2900, supporting member 2801 is bonded with each other with pin 2815.Supporting member 2801 and pin 2815 can limit spherical surface 2907 when being bonded with each other.Spherical surface 2907 can be centered in pin 2815 places, and comprises radius r 10.Indicator 2803 can be arranged to inlet point 2903.Inlet point 2903 can be positioned near the intersection of soft tissue (not shown) spherical surface 2907 and bone B.

Supporting member 2801 can be arranged to the inlet point corresponding with the implantation piece with the first length.Supporting member 2801 can be arranged to represent for having the inlet point of the implantation piece of the second length.Implantation piece can be arranged to repair the fractures F in bone B.

For the implantation piece with the first length, supporting member 2801 can be arranged to limit spherical surface, and this spherical surface is characterised in that radius r 10.When supporting member 2801, being arranged to limit the spherical surface Shi， extension 2817 be characterized as radius r 10 can be positioned at a certain distance from brake 2,909 2905 places.

For the implantation piece with the second length, supporting member 2801 can be arranged to limit spherical surface, this spherical surface be characterized as the radius less than the value of radius r 10.When supporting member 2801 is arranged to represent can be positioned substantially near brake 2909 for having the inlet point Shi， extension 2817 of the implantation piece of the second length.

Extension 2817 can be with hold-down screw 2819 with respect to brake 2909 location.Hold-down screw 2819 can use in receptor 2811(Figure 28 and represent) fix, this receptor 2811 is for having the implantation piece of the first length.Hold-down screw 2819 can use in receptor 2813(Figure 28 and represent) fix, this receptor 2813 is for having the implantation piece of the second length.

Boring 2901 can be positioned near indicator 2803.Bore 2901 and can penetrate bone B at inlet point 2903 places.

Figure 30 has represented exemplary device 3000.Device 3000 can comprise one or more features of device 2800.Device 3000 can comprise supporting member 3011.Supporting member 3011 can comprise extension 3001,3009,3003 and 3007.

Device 3000 can comprise lining 3005.Lining 3005 can comprise sleeve pipe 3013.Sleeve pipe 3013 can receive pin 2701.Sleeve pipe 3013 can limit the concave surface of lining 3005.Pin 2701 can be hinged against the concave surface of lining 3005.Supporting member 3011 can be hinged with respect to pin 2701.Comprise for receiving the supporting member of the lining 3005 of pin 2701 and can limit supporting member with respect to the motion of pin 2701.Supporting member can reduce measurement error with respect to the constrained motion of pin 2701 when determining the inlet point of target site of bone B inside.

Figure 31 has represented signal module 3150.Module 3150 example shown can in device 3000(Figure 30, represent) in the principle that realizes.Module 3150 has represented a little 3120,3122 and 3124. Point 3120,3122 and 3124 can be inner at bone B.Each point 3120,3122 and 3124 can be with for example, for the position of bone implantation piece (implantation piece 300, represent in Fig. 3 B) corresponding.

Each point 3120,3122 and 3124 can be on line 3127.Line 3127 can be for example, with pin (sell in 2701, Figure 27 and represent) corresponding, and this pin is fixed into angle w with respect to bone B.

Line 3117 can represent even distance.Line 3117 can represent the length of bone implantation piece, and for example implantation piece 300.Line 3117 can be fixed on the orientation vertical with line 3127.Line 3117 can represent to be vertically fixed on the pointer on line 3127.In the time of on being vertically fixed on line 3127, line 3117 has been determined the point with the spaced apart even distance 3117 of line 3127.

Line 3119 can be vertically fixed on line 3117.Line 3119 coiling 3127 off-line 3127 distance 3117 places rotations can determine on bone B, with the position of line 3127 spaced apart 3117.Line 3119 can represent joint element, and this joint element is determined points in the convex surface of bone B, off-line 3127 distances 3117, for example, put 3121,3123 and 3125.The joining of line 3119 and bone B can be illustrated in the inlet point on bone B, for example H ' or I ' (in Fig. 3 A, representing).

The variation of angle w can so that line 3119 determine and point 3121,3123 or 3125 different points, but this is named a person for a particular job and remains on off-line 3119 apart from 3117 places.

Figure 32 has represented exemplary pin 3200.Pin 3200 can comprise one or more features of pin 3701.Pin 3200 can comprise the axle collar 3215.The axle collar 3215 can comprise brake 3211.The axle collar 3215 can comprise brake 3213.

Brake 3211 can limit end 3205 enter in bone section Bs(Figure 27 represent) in maximum penetration.Maximum penetration can be corresponding to distance 3209.Brake 3213 can limit supporting member 3011 or supporting member 2801 higher than the minimum constructive height of bone section Bs.This minimum constructive height can be corresponding to distance 3207.

Figure 33 has represented exemplary device 3300.Device 3300 can comprise supporting member 3302.Supporting member 3302 can comprise fixture 3301.Fixture 3301 can comprise receptor 3309.Receptor 3309 can be configured to receive in pin 3203(Figure 32 and represent).Receptor 3309 can be configured to receive in pin 2701(Figure 27 and represent).Supporting member 3300 can be hinged against the pin being received by receptor 3309.Supporting member 3300 can be around the pin pivotable being received by receptor 3309.Supporting member 3300 is around pin pivotable and inswept spherical surface 3311.

Supporting member 3300 can comprise extension 3303.Extension 3302 can be arranged to extend along spherical track 3313.Extension 3303 can be extended along guide rail 3307.

Extension 3303 can comprise indicator 3305.Indicator 3305 can be arranged to indicate inlet point.Inlet point can be corresponding near the joining of soft tissue spherical surface 3311 and bone B.

Indicator 3305 can be left extension 3303 along spherical track 3315 and extend.Track 3315 can with track 3313 quadratures.Extension 3303 can be extended along track 3313, until near the soft tissue 3303 contact bone B of extension.Extension 3303 can be extended along track 3313, until near soft tissue indicator 3305 contact bone B.Indicator 3305 indications are for the inlet point in target site is inserted bone B by implantation piece.

Figure 34 has represented exemplary device 3400.Device 3400 can have the one or more features common with device 3300.Pin 3203 can be fixed in bone section, for example, in bone section Pa, Ph, Pb(Fig. 3 A, represent) or Bs(Figure 27 in represent).Brake 3211 can limit fixture 3301 with respect to the minimum constructive height of bone section.Brake 3213 can limit fixture 3301 higher than the maximum height 3207 of bone section.

Pin 3203 and supporting member 3302 can be arranged so that indicator 3305 points to along representing in spherical track 3315(Figure 33) inlet point.Pin 3203 and supporting member 3302 can be arranged so that can be corresponding to the end 3205 of pin 3203 for the target site of implantation piece.Inlet point along spherical track 3315 can basic the first distance in Shi Li end 3205.This distance can correspond essentially to the value of radius r 11.The spherical track 3313 of extension 3303 can be from end 3205 second distances.This second distance can correspond essentially to the value of radius r 12.

The value of radius r 11 can correspond essentially to the value of radius r 12.Track 3313 can be perpendicular to track 3315.Radius r 11 can be perpendicular to radius r 12.The first distance can equal second distance.

End 3205 can be the center of spherical track 3313.End 3205 can be to represent in spherical track 3315(Figure 33) center.End 3205 can be corresponding to the target site of bone B inside.Indicator 3305 can be associated with the known distance (r11) from target site.Indicator 3305 can determine on bone B, from the inlet point of target site known distance.Indicator 3305 can determine on bone B, from the inlet point of target site known distance (irrelevant with the anatomical structure difference of bone B).Indicator 3305 can as one man determine on bone B, from the inlet point of target site known distance.

Figure 35 has represented the signal module 3550 of example.Module 3550 examples have illustrated and can in 3400(Figure 34, represent for example installing) in the principle implemented.Module 3550 has represented a little 3552.Point 3552 can be in the inside of bone B.Point 3552 can be corresponding with the position of for example, end for bone implantation piece (implantation piece 300, represent in Fig. 3 B).Bone implantation piece can have the length suitable with line 3117.

Point 3552 can be on line 3557.Line 3557 can be for example, with pin (sell in 2701, Figure 27 and represent) corresponding, and this pin is fixed on angle W place with respect to bone B.Point 3552 can be that spherical surface 3563(represents with cross section) center.

Each line 3552,3554 and 3556 is radiuses of spherical surface 3563, and has the corresponding endpoint 3551,3553 and 3555 in the surperficial convex part of bone B.Each end points 3551,3553 and 3555 is therefore spaced apart 3117 with point 3553, and is the suitable candidate that enters hole (for configuring the implantation piece with length 3117) for arranging.

Figure 36 has represented exemplary device 3600.Device 3600 can comprise supporting member 3611.Supporting member 3611 can comprise receptor 3619.Receptor 3619 can directing pin 2701 enter in bone section Bs.Supporting member 3611 can comprise labelling 3609.Labelling 3609 can be seen under fluorescence imaging effect.Labelling 3609 can so that supporting member 3611 with respect to bone B, locate.Labelling 3609 can so that supporting member 3611 along representing in bone B(Fig. 3 A) centre line L b location.Labelling 3609 can be according to aliging for inserting the target site of the implantation piece of bone B.

Supporting member 3611 can be located so that pin 2701 moves the cartilage lower surface 3603 along bone B when inserting through receptor 3619.Supporting member 3611 can be around axis Ps pivotable.Supporting member 3611 can be around axis Ps pivotable, to reduce the displacement that represented by arrow 3617.Displacement 3617 can be corresponding to guiding piece 3601 distance from bone B.

Device 3600 can comprise guiding piece 3601.Guiding piece 3601 can be positioned on bone B.Align unit 3613 can be so that guiding piece 3601 aligns on bone B.Guiding piece 3601 can comprise guiding surface 3615.Guiding surface 3615 can be positioned to guide Surigical tool (for example bore in 2901, Figure 29 and represent) into inlet point on bone B.Guiding piece 3601 can be positioned at the lateral side of bone B.Guiding piece 3601 can be positioned at the medial side of bone B.

Device 3600 can comprise bone penetrating parts 3607 and 3605. Bone penetrating parts 3607 and 3605 can be inserted in cortical bone BCO(Fig. 3 A of bone B and represent) in.Bone penetrating parts 3605 can be inserted in bone B through receptor 3621.Receptor 3621 can be arranged so that bone penetrating parts 3605 is in " skew nailing (toe-nail) " position introducing bone B.Bone penetrating parts 3607 can be inserted in radius R through receptor (not shown). Bone penetrating parts 3607 and 3605 can be so that guiding piece 3601 be stabilized on bone B.

Figure 37 has represented exemplary device 3700.Device 3700 can comprise fixture 3702.Fixture 3702 can comprise in fixture 1000(Figure 10 and representing) one or more features.

Device 3700 can comprise bridging component 3715.Bridging component 3715 can comprise receptor 3723 and 3724.Receptor 3723 can be configured to receive the first bone penetrating parts, for example, in bone penetrating parts 1007(Figure 10, represent).The first bone penetrating parts can be fixed on the first bone section, for example, in bone section Pa or Ph(Fig. 3 A, represent).

Receptor 3724 can be configured to receive the second bone penetrating parts, for example, in bone penetrating parts 1001(Figure 10, represent).The second bone penetrating parts can be fixed in the second bone section, for example, in bone section Pa or Ph(Fig. 3 A, represent).The first and second bone penetrating parts can so that the first bone section with respect to the second bone section, locate.The first and second bone penetrating parts can be fixed on the dorsal part (representing in Fig. 3 A) of bone B.

Device 3700 can comprise supporting member 3717.Supporting member 3717 can be connected with base portion 3719.Base portion 3719 can comprise receptor 3721.Receptor 3721 can be configured to receive the 3rd bone penetrating parts being fixed on reference in bone section.The 3rd bone penetrating parts can so that the first and second bone sections with respect to locating with reference to bone section.

Bridging component 3715 can be fixed the first bone section with respect to the second Gu Duan position.Bridging component 3715 and base portion 3719 can be fixed the first and second bone sections with respect to reference to Gu Duan position.Device 3700 can the Fa of reseting fracture portion and Fh(Fig. 3 A in represent).

Receptor 3731 can be configured to receive pin 2701.Supporting member 3727 can be hinged against pin 2701.Supporting member 3727 can fix by hold-down screw 3725 with respect to the position of conduit 3729.

Device 3700 can comprise guiding piece 3709.Guiding piece 3709 can with supporting member 3727 mechanical coordinations.Supporting member 3727 can be positioned at guiding piece 3709 lateral side of bone B.Supporting member 3727 can so that guiding piece 3709 with respect to locating at the position of fractured bones inside.Guiding piece 3709 can comprise guiding surface 3711.Guiding surface 3711 can be so that the alignment of Surigical tool Yu Gai position.

Device 3700 can comprise guiding surface extender 3713.Guiding surface extender 3713 can so that guiding surface extension (not shown) with respect to locating with reference to bone section.The rotation of guiding surface extender 3713 can fixed guide surface extension with respect to reference to Gu Duan position.

Device 3700 can comprise conduit 3703 and 3707.Bone penetrating parts 3705 and 3707 can represent through in cortical bone BCO(Fig. 3 A through conduit 3707 and 3703 respectively) insert.Bone penetrating parts 3705 and 3707 can be so that guiding piece 3709 be stable on bone B.Bone penetrating parts 3705 and 3707 can be K line.Bone penetrating parts 3705 and 3707 can be used wire drill (wire drill) to insert in bone B.

Device 3700 can comprise align unit 3733 and 3701. Align unit 3733 and 3701 makes guiding piece 3709 along aliging with reference to bone. Align unit 3733 and 3701 can so that guiding piece 3709 along representing in bone B(Fig. 3 A) centre line L B alignment.

Figure 38 has represented exemplary device 3800.Device 3800 can comprise fixture 3801.Fixture 3801 can comprise in fixture 1000(Figure 10 and representing) one or more features.

Device 3800 can comprise bridging component 3837.Bridging component 3837 can comprise receptor 3823 and 3825. Receptor 3823 and 3825 can be configured to receive bone piercing elements, for example, in bone penetrating parts 1312 and 1314(Figure 13, represent). Bone penetrating parts 1312 and 1314 can be fixed in bone section separately, for example, in bone section Ph or Pa(Fig. 3 A, represent).Hold- down screw 3827 and 3829 can bone fixation piercing elements 1312 and 1314 positions with respect to bridging component 3837.

Bridging component 3837 can be arranged to the pivotable around axis Z.Axis Z can locate with respect to the position of bone B inside.Device 3800 can comprise the labelling (not shown) around axis Z location.This labelling can comprise in labelling 3609(Figure 36 and representing) one or more features.Labelling can be located with respect to the position of bone B inside by aid-device 3800.Bridging component 3837 can locate around the rotation of axis Z the bone section being fixed on bone penetrating parts 1312 and 1314.Bridging component 3837 can fix by hold-down screw 3831 around the position of axis Z.

Device 3800 can comprise base portion 3803.Device 3800 can comprise the axle collar 3805.The axle collar 3805 can comprise receptor 3833 and 3835.Bone penetrating parts for example 1311 and 2601(Figure 26 in represent) can be received by receptor 3833 and 3835.Bone penetrating parts for example 1311 and 2601 can be so that base portion 3803 be for example fixed on, with reference to bone section (bone section Pb, represents in Fig. 3 A).Hold-down screw 3839 can so that the axle collar 3805 with respect to base portion 3803 location.

Device 3800 can be arranged so that bone section Pa locates with respect to bone section Ph.Device 3800 can be arranged so that bone section Pa and Ph locate with respect to bone section Pb.Device 3800 can be arranged to lock the relative position of bone section Pb, Pa and Ph.

Device 3800 can comprise supporting member 3811.Supporting member 3811 can be around axis Z pivotable.Supporting member 3811 can comprise extension 3813.Extension 3813 can be with respect to being with 3815 translations.Hold-down screw 3841 can securing elongated part 3813 with respect to the position with 3815.Supporting member 3811 and extension 3813 can be arranged so that guiding piece 3807 locates with respect to bone B.Align unit 3817 and 3819 can be so that represent in centre line L b(Fig. 3 A of guiding piece 3807 with respect to bone B) location.Leading end 3849 can be illustrated in the inlet point on bone B.Guiding surface 3847 can be oriented so that Surigical tool is in the alignment of the inlet point place of indication.

Guiding piece 3807 can comprise conduit 3843 and 3845. Bone penetrating parts 3805 and 3807 can be inserted in cortical bone BCO(Fig. 3 A and represent through conduit 3707 and 3703) in, to guiding piece 3807 is stabilized on bone B.Extension 3813 can comprise receptor 3821.Bone penetrating parts can be inserted in cortical bone BCO(Fig. 3 A and represent through receptor 3821) in, to device 3800 is stabilized on bone B.Bone penetrating parts can be inserted in cortical bone BCO, to produce pilot hole in bone B through receptor 3821.

Figure 39 has represented exemplary device 3900.Device 3900 can have with fixture 1000(Figure 10 in represent) or fixture 1300(Figure 13 in represent) common one or more features.

Device 3900 can comprise bridging component 3905.Bridging component 3905 can comprise receptor 3907 and 3909.Receptor 3907 can be configured to receive bone penetrating parts 3921 and 3919.It is upper that bone penetrating parts 3921 can be fixed on bone section Pa, and the position of bone penetrating parts 3921 can be used the hold-down screw (not shown) inserting in receptor 3931 and be fixed with respect to bridging component 3905.

Bone penetrating parts 3919 can be fixed on bone section Ph.The position of bone penetrating parts 3919 can be used the hold-down screw (not shown) inserting in receptor 3929 and be fixed with respect to bridging component 3905.Device 3900 can be arranged so that bone section Ph locates with respect to bone section Pa.

Device 3900 can comprise base portion extension 3911 and 3913.Base portion extension 3913 can comprise receptor 3915.Receptor 3915 can be configured to receive bone penetrating parts 3925.Base portion extension 3913 can comprise receptor (not shown), and this receptor is configured to receive bone penetrating parts 3923.Bone penetrating parts 3925 and 3923 can be fixed on bone section Pb.Bone penetrating parts 3925 and 3923 can be fixed with respect to base portion extension 3913 by one or more hold-down screw (not shown).Can there be the one or more features common with base portion extension 3913 base portion extension 3911.

Device 3900 can be arranged so that bone section Pa is with respect to the centralized positioning of bone section Pa.Device 3900 can be arranged so that bone section Ph is with respect to the centralized positioning of bone section Ph.Device 3900 can be arranged to bone fixation section Ph and Pa with respect to Gu DuanPb position.Device 3900 can be arranged to the Fh of reseting fracture portion and Fa.

Device 3900 can comprise guide support 3903.Guide support 3903 can be arranged to rotate around axis P1.Guide support 3903 can be fixed by tightening hold-down screw 3917 around axis P1 position.Guide support 3903 can be located with respect to bone section Pb around axis P1.Guide support 3903 can comprise knob brake 3927.Guide support 3903 can comprise hinged surperficial 3931.Guide support 3903 can be fixed on the dorsal part of bone B.

Figure 40 has represented exemplary device 4000.Device 4000 can have the one or more features common with device 3900.Device 4000 can be with respect to the spots localization of bone B inside.Labelling 4019 can be seen under fluorescence imaging effect.Labelling 4019 can position with respect to the position of bone B inside.

Device 4000 can comprise guiding extension 4023. Guiding extension 3903 and 4023 can be arranged so that guiding piece 4021 locates with respect to bone B.Guiding extension 3903 can be around axis P1 pivotable.In hinged surperficial 3931(Figure 39, represent) can be positioned at from bone B a distance.Hinged surperficial 3931 position can be used in hold-down screw 3917(Figure 39 and be represented) fix.

Guiding extension 3903 can be arranged to against hinged surperficial 3931 hinged.Guiding extension 4023 can be around axis P2 pivotable.Guiding extension 4023 can be arranged so that guiding piece 4021 and the guiding axle collar 4015 align with bone B.

Guiding piece 4021 and the guiding axle collar 4015 can separate with guide support 3903.Guiding piece 4021 and the guiding axle collar 4015 can represent in fractures Fa and Fh(Figure 39) separate with guide support 3903 in the process that resets.Guiding piece 4021 and the guiding axle collar 4015 separate with bone B the substantially without hindrance observation that bone B can be provided in reset processing process.

Guiding extension 4023 can comprise shell 4025.Guiding extension 4023 can be fixed on around axis P2 position by knob brake 3927.Knob brake 3927 can remain on default location by spring (not shown).Knob brake 3927 can comprise most advanced and sophisticated 4027.Most advanced and sophisticated 4027 can be arranged to stretch in shell 4025.Knob brake can discharge guiding piece 4021 and the guiding axle collar 4015 from guide support 3903 along the translation of axis P2.Knob brake can discharge most advanced and sophisticated 4027 from shell 4025 along axis P2 translation.

The guiding axle collar 4015 can be arranged to guiding piece 4021 to be positioned on bone B.The guiding axle collar 4015 can comprise align unit 4009 and 4011. Align unit 4009 and 4011 can be along representing in centre line L B(Fig. 3 A of bone B) orientation direction part 4021.Receptor 4013 can be configured to receive bone penetrating parts 4005.Receptor (not shown) can be configured to receive bone penetrating parts 4007.Receptor can have the one or more features common with receptor 4013. Bone penetrating parts 4005 and 4007 can be fixed on bone B. Bone penetrating parts 4005 and 4007 can be fixed on bone B in " skew nailing " structure. Bone penetrating parts 4005 and 4007 can the fixed guide axle collar 4015 with respect to the position of bone B.

Insert 4029 can be arranged to be positioned at the guiding axle collar 4015 inside.Insert 4029 can comprise indicator 4017.Indicator 4017 can be indicated the position in bone B inside.This position can be corresponding to the target site of implantation piece, and this implantation piece is arranged to keep the reset of fractures Fa and Fh.Insert 4017 can locate or dismantle from the guiding axle collar 4015 with handle 4001.Insert 4017 can be from 4015 dismountings of the guiding axle collar after the guiding axle collar 4015 is fixed on bone B.

Handle 4001 can comprise lining 4003.Lining 4003 can be configured to receive bone penetrating parts.Bone penetrating parts can be fixed on bone B.Lining 4003 can be arranged to indicate inlet point (representing in Figure 29).Inlet point can be corresponding to the position of bone B inside.Lining 4003 can represent so that Surigical tool for example bores in 2901(Figure 29) be positioned at inlet point place.

Figure 41 has represented exemplary device 4100.Device 4100 can comprise the axle collar 4143.The axle collar 4143 can comprise and departs from parts 4139.Depart from parts 4139 and can comprise receptor 4119.Receptor 4119 can be configured to receive bone penetrating parts.Bone penetrating parts can be fixed in bone section, for example, in bone section Pa or bone section Ph(Fig. 3 A, represent).

The position of bone penetrating parts can be fixing with respect to departing from parts 4139.Depart from parts 4139 and can comprise receptor 4121.Receptor 4121 can be configured to receive hold-down screw (not shown).Hold-down screw can bone fixation penetrating parts with respect to the position of departing from parts 4139.

The axle collar 4143 can be arranged to the mobile bone section in bone penetrating parts that is fixed on.The axle collar 4143 can be arranged so that bone section moves with respect to Gu Duan center.Gu Duan center can be corresponding to representing in initial point O1 or O2(Fig. 7).The axle collar 4143 can be arranged so that bone section moves along three quadrature-axis.The axle collar 4143 can be arranged so that bone section rotates around three quadrature-axis.

The axle collar 4143 can be arranged to rotate around axis P4143.The axle collar 4143 can be arranged so that bone section is around axis 4143 rotations.Depart from parts 4139 and can comprise receptor 4147.Receptor 4147 can be configured to receive hold-down screw (not shown).Hold-down screw can fixedly depart from parts 4139 around the position of axis P4143.

The axle collar 4143 can be arranged so that bone section moves along axis X, Y and Z.The axle collar 4143 can be arranged so that bone section is around axis X, Y and Z rotation.

Device 4100 can comprise collar receiver part 4145.Collar receiver part 4145 can comprise hemisphere 4125 and hemisphere 4127.Hemisphere 4125 can comprise receptor 4123.Hemisphere 4127 can comprise interior threaded part 4129.Receptor 4123 can be configured to receive hold-down screw (not shown).Hold-down screw can comprise external screw thread, and this external screw thread is arranged to engage with interior threaded part 4129.The joint of hold-down screw and interior threaded part 4129 fixedly the axle collar 4143 along the position of axis X, Y and Z.The joint of hold-down screw and interior threaded part 4129 fixedly the axle collar 4143 around the position of axis X, Y and Z.

Device 4100 can comprise central module 4101.Central module 4101 can comprise receptor 4107 and 4109. Receptor 4107 and 4109 can be configured to receive bone penetrating parts separately.Bone penetrating parts can be fixed in bone section, for example, in bone section Pb(Fig. 3 A, represent).Central module 4101 can be arranged to device 4100 to be fixed on reference in bone section.Central module 4101 can be located with respect to bone section.

Central module 4101 can comprise receptor 4105 and 4103. Receptor 4105 and 4103 can be configured to receive hold-down screw (not shown) separately.Hold-down screw can be fixed the position by receptor 4107 or the 4109 bone penetrating parts that receive.Hold-down screw can fixed center parts 4101 with respect to the position of bone penetrating parts.Hold-down screw can fixed center parts 4101 with respect to the Gu Duan position of being fixed in bone penetrating parts.

Device 4100 can comprise guide rail 4102 and base portion 4111.Guide rail 4102 can be rigidly secured on central module 4101.Guide rail 4102 can comprise receptor 4115.Receptor 4115 can be configured to receive hold-down screw (not shown).Hold-down screw can be fixed on base portion 4111 on guide rail 4102.Base portion 4111 can be arranged to along axis L4111 with respect to guide rail 4102 translations.Hold-down screw can fixed base 4111 with respect to the position of guide rail 4102.

Base portion 4111 can comprise bracket 4141.Bracket 4141 can be rigidly secured on base portion 4111.Bracket 4141 can comprise receptor (not shown).Receptor can be configured to receive hemisphere 4125.Bracket 4141 can be fixed on hemisphere 4125.

Device 4100 can be arranged so that bone section Pa locates with respect to bone section Ph.Device 4100 can be arranged to bone fixation section Pa with respect to Gu DuanPh position.

Device 4100 can be arranged to respect to handle two or more bone sections with reference to bone section.Device 4100 can comprise the axle collar 4142, collar receiver part 4144, bracket 4140 and base portion 4110.The axle collar 4138 can have the one or more features common with the axle collar 4143.Collar receiver part 4144 can have the one or more features common with collar receiver part 4145.Bracket 4140 can have the one or more features common with bracket 4141.Base portion 4110 can have the one or more features common with base portion 4111.

Device 4100 can be arranged so that bone section Pa and bone section Ph are with respect to representing in bone section Pb(Fig. 3 A) location.Device 4100 can be arranged to represent in the Fa of reseting fracture portion and Fh(Fig. 3 A).

Device 4100 can comprise slider 4131.Slider 4131 can be arranged to respect to guide rail 4102 translations.Device 4100 can comprise aiming elements 4133.Aiming elements 4133 can be arranged to respect to slider 4131 translations.Aiming elements 4133 can comprise nose 4149.Nose 4149 can comprise labelling 4137.Labelling 4137 can be so that install 4100 spots localization with respect to bone B inside.Labelling 4137 can be visible in fluorescence imaging process.

Figure 42 has represented exemplary components 4200.Parts 4200 can comprise the axle collar 4143.The axle collar 4143 can comprise hinged surperficial 4205.Hinged surperficial 4205 can comprise spherical curvature.Hinged surperficial 4205 can be arranged to along axis X, Y or Z translation.Hinged surperficial 4205 can be arranged to around axis X, Y or Z rotation.

Parts 4200 can comprise collar receiver part 4145.Collar receiver part 4145 can comprise hemisphere 4145 and hemisphere 4127.Hinged surperficial 4205 can be arranged to against hemisphere 4125 hinged.Hinged surperficial 4205 can be arranged to against hemisphere 4127 hinged.

Hemisphere 4127 can comprise interior threaded part 4129.Hold-down screw 4201 can be arranged to be threadedly engaged with interior threaded part 4129.Hemisphere 4125 can comprise receptor 4123.Receptor 4123 can be configured to receive hold-down screw 4201.Being threadedly engaged with of hold-down screw 4201 and interior threaded part 4129 can be so that hemisphere 4125 and 4127 presses hinged surperficial 4205.

Make hemisphere 4125 and hemisphere 4127 press hinged surperficial 4205 fixedly the axle collar 4143 along the position of axis X, Y and Z.Make hemisphere 4125 and hemisphere 4127 press hinged surperficial 4205 fixedly the axle collar 4143 around the position of axis X, Y and Z.Make hemisphere 4125 and hemisphere 4127 press hinged surperficial 4205 can bone fixation section (being fixed on the axle collar 4143) position.Gu Duan position can be fixed with respect to Gu Duan center.This center can be corresponding to representing in initial point O1 and O2(Fig. 7).Gu Duan position can be with respect to fixing with reference to bone section.

Hemisphere 4125 can comprise edge 4211.Hemisphere 4209 can comprise edge 4209.The axle collar 4143 can comprise interior threaded part 4207.It is hinged that interior threaded part 4207 can be arranged to the part of abutment edges 4211.It is hinged that interior threaded part 4207 can be arranged to the part of abutment edges 4209.

Interior threaded part 4207 can be arranged to be threadedly engaged with hold-down screw 4203.Being threadedly engaged with of hold-down screw 4203 and interior threaded part 4207 can fixedly depart from arm 4139 around the position of axis P4143.Hold-down screw 4203 and interior threaded part 4207 be threadedly engaged with can bone fixation section (being fixed on the axle collar 4143) position.Gu Duan position can be fixed with respect to axis P4143.Gu Duan position can be fixed with respect to Gu Duan center.Gu Duan center can be corresponding to initial point O1 or O2.

Figure 43 has represented exemplary components 4300.Parts 4300 can comprise hinged surperficial 4205.Hinged surperficial 4205 can comprise receptor 4301.Receptor 4301 can be configured to receive in hold-down screw 4201(Figure 42 and represent).

Figure 44 has represented to represent in 44-44(Figure 42 along the line) section 4400.Section 4400 has represented to represent in hold-down screw 4201(Figure 42) through in receptor 4301(Figure 43, represent).Section 4400 has represented to represent in hold-down screw 4201 and interior threaded part 4129(Figure 41) be threadedly engaged with.

Section 4400 has represented to represent through in receptor 4147(Figure 41) hold-down screw 4203.Section 4400 has represented the hold-down screw 4203 being threadedly engaged with interior threaded part 4207.

Figure 45 has represented exemplary device 4500.Device can have the one or more features common with device 4100.Device 4500 can comprise in slider 4131(Figure 41 and representing).Slider 4131 can be arranged to the translation along axis L4131.Slider 4131 can be arranged to respect to guide rail 4501 and 4102 translations.

Device 4500 can comprise central module 4101.Central module 4101 can be fixed in bone section.Slider 4131 can be arranged to respect to the translation of bone section.

Device 4500 can comprise aiming elements 4133.Aiming elements 4133 can comprise nose 4149 and labelling 4137.Labelling 4137 can comprise template 4505.Template 4505 can be visible in fluorescence imaging process.Aiming elements 4133 can be arranged to the translation along axis H4149.

The translation of slider 4131 can be along axis L4131 telltale mark.Along axis L4131 translation, can carry out telltale mark 4137 with respect to the position of bone B inside.The translation of aiming elements 4133 can carry out telltale mark 4137 along axis H4133.Along axis H4133 translation, can carry out telltale mark 4137 with respect to the position of bone B inside.

Slider 4131 can comprise receptor 4511.Hold-down screw (not shown) and receptor 4511 be threadedly engaged with fixedly slider 4131 with respect to the position of guide rail 4501 and 4102.Aiming elements 4133 can comprise receptor 4513.Hold-down screw (not shown) and receptor 4513 be threadedly engaged with fixedly aiming elements 4133 with respect to the position of slider 4131.

Device 4500 can comprise supporting member 4503.Supporting member 4503 can comprise snap ring 4509.Snap ring 4509 can be arranged to against cylindrical surface 4135 hinged.Supporting member 4503 can be arranged to hinged with respect to aiming elements 4133.

Supporting member 4503 can comprise indicator 4507.Indicator 4507 can be arranged to the inlet point on bone B.Supporting member 4503 can be arranged near the inlet point at the joining place of soft tissue indicator 4507 and bone B.Indicator 4507 can be arranged to coordinate with guiding piece (not shown).Inlet point can be corresponding to the position of bone B inside.Inlet point can be corresponding to the position of being determined by labelling 4137.

Figure 46 has represented exemplary device 4600.Device 4600 can comprise base portion 4601.Base portion 4601 can comprise conduit 4643.Device 4600 can comprise slider 4603.Slider can comprise receptor 4647 and 4645.Receptor 4643 can be configured to receive bone penetrating parts 4637.Receptor 4645 can be configured to receive bone penetrating parts 4635.Bone penetrating parts 4637 and 4635 can be fixed on bone section Pb.Bone penetrating parts 4637 and 4635 can be fixed on slider 4603 on bone section Pb.Hold-down screw 4639 and 4641 fixedly slider 4603 with respect to the height of bone section Pb.

In conduit 4643, slider 4603 can be arranged to respect to base portion 4601 translations.Hold-down screw 4605 fixedly slider 4603 with respect to the position of base portion 4601.

Device 4600 can comprise the axle collar 4607.The axle collar 4607 can comprise hinged surperficial 4615.Hinged surperficial 4615 can comprise substantially spherical curvature.The axle collar 4607 can comprise plane surface 4614.Plane surface 4614 can comprise receptor 4651.Receptor 4651 can be configured to receive bone penetrating parts 4631.Bone penetrating parts 4633 can be fixed on bone section Pa.

Device 4600 can be arranged to along axis X, Y and Z location bone section Pa.Device 4600 can be arranged so that bone section Pa is around axis X, Y and Z rotation.Axis Z can depart from bone penetrating parts 4631.

Device 4600 can be arranged to locate bone section Pa with respect to Gu DuanPa center.Gu DuanPa center can be corresponding to representing in initial point O2(Fig. 7).Device 4600 can be arranged so that bone section Pa locates with respect to bone section Pb.Device 4600 can be arranged so that bone section Pa locates with respect to bone section Ph.

Device 4600 can comprise collar receiver part 4614.Hinged surperficial 4615 can be hinged against collar receiver part 4614.Collar receiver part 4614 can comprise extension 4653 and 4655.Hold-down screw 4617 can be arranged to around plane Z-Y compression extension 4653 and 4655.Extension 4653 and 4655 compression can be exerted pressure to hinged surperficial 4615.Pressure fixedly the axle collar 4607 with respect to the position of collar receiver part 4614.Pressure can bone fixation penetrating parts 4631 position.Pressure can bone fixation section Pa with respect to initial point O2 position.

Device 4600 can comprise the axle collar 4620.The axle collar 4620 can comprise hinged surperficial 4619.Hinged surperficial 4619 can have and hinged surperficial 4615 common one or more features.The axle collar 4620 can comprise extension 4609.Can there be the one or more features common with collar receiver part 4614 extension 4609.Can there be the one or more features common with the axle collar 4607 extension 4609.Extension 4609 can be configured to receive bone penetrating parts 4629.Bone penetrating parts 4629 can be fixed on bone section Pa and Ph.Bone penetrating parts 4629 can bridge joint fractures Fa.

The axle collar 4620 can be arranged to bone fixation section Pa and Ph with respect to Gu DuanPb position.Hold-down screw 4621 can be fixedly hinged surface 4619 positions with respect to collar receiver part 4618.Hold-down screw 4627 can be fixedly hinged surface 4625 positions with respect to extension 4609.Hold-down screw 4621 and 4627 can bone fixation section Pa and Ph with respect to Gu DuanPb position.

Device 4600 can comprise the axle collar 4611.The axle collar 4611 can be configured to receive bone penetrating parts 4633.Bone penetrating parts 4633 can be fixed on bone section Ph.The axle collar 4611 can have the one or more features common with the axle collar 4607.The axle collar 4611 can be arranged to represent in initial point O1(Fig. 7) location bone section Ph.Device 4600 can comprise collar receiver part 4657.Collar receiver part 4657 can have the one or more features common with collar receiver part 4614.

Hold-down screw 4613 can be arranged to fixedly the axle collar 4611 with respect to the position of collar receiver part 4657.Hold-down screw 4613 can be arranged to bone fixation section Ph with respect to initial point O1 position.

Figure 47 has represented exemplary device 4700.Device 4700 can comprise bridging component 4707.Bridging component 4707 can comprise receptor 4701.Receptor 4701 can be configured to receive bone penetrating parts.Receptor 4701 can be provided for a plurality of positions of one or more bone penetrating parts.Device 4700 can comprise pressure distribution parts (see Figure 10 1013).Pressure distribution parts can be arranged to the position of the fixing one or more bone penetrating parts that received by receptor 4701.

Device 4700 can comprise bridging component 4705.Bridging component 4705 can comprise receptor 4703.Bridging component 4705 can have the one or more features common with bridging component 4707.

Supporting member 4709 can cross structure relay part 4707 and bridging component 4705.Supporting member 4709 can be rigidly connected bridging component 4707 and bridging component 4705.Supporting member 4709 can comprise articulated section (not shown).

Figure 48 A has represented exemplary device 4800.Device 4800 can comprise supporting member 4803.Supporting member 4803 can be arranged to support soft tissue 4808.Soft tissue 4808 can be corresponding to the first osteocomma (not shown).

Device 4800 can comprise supporting member 4807, supporting member 4807 substantially fixedly soft tissue 4808 with respect to the position of supporting member 4803.Supporting member 4807 can be fixed the first osteocomma substantially with respect to the position of supporting member 4803.

Device 4800 can comprise supporting member 4801.Supporting member 4801 can be arranged to support soft tissue 4809.Soft tissue 4809 can be corresponding to the second osteocomma (not shown).

Device 4800 can comprise supporting member 4811.Supporting member 4811 can comprise soft tissue grasper 4823.Supporting member 4811 can comprise stretching knob 4815.Supporting member 4811 can comprise spring 4819.Supporting member 4811 can comprise stretcher 4817.

Supporting member 4811 can be arranged to apply tensile force to soft tissue 4809.Tensile force can so that the second osteocomma from the first osteocomma, remove.Soft tissue grasper 4823 can be arranged to when the first osteocomma is removed increase, apply the tensile force of increase when the second osteocomma.

Supporting member 4811 can be arranged to substantially fixedly soft tissue 4809 with respect to the position of supporting member 4801.Supporting member 4811 can be fixed the first bone section substantially with respect to the position of supporting member 4803.

Device 4800 can comprise supporting member 4813.Supporting member 4813 can have the one or more features common with supporting member 4811.

Device 4800 can comprise supporting member 4825.Supporting member 4825 can comprise receptor 4821.Receptor 4821 can be arranged to be threadedly engaged with the knob 4815 that stretches.Stretching knob 4815 and receptor 4821 be threadedly engaged with the tensile force that can increase in spring 4819.Tensile force in spring 4821 can be increased in the tensile force on stretcher 4817 and soft tissue grasper 4823.Increase tensile force on soft tissue grasper 4823 can increase the traction to soft tissue 4809.

Device 4800 can comprise hold-down screw 4805.Hold-down screw 4805 can be arranged to fixed support 4803 with respect to the position of supporting member 4801.Hold-down screw 4805 can be arranged to fix the first bone section with respect to the second Gu Duan position.Device 4800 can be arranged to reset in fractures Fa in bone B and Fh(Fig. 3 A and represent).

Device 4800 can be by apply power in making the bone section stretching relative to each other of bone B, translation, angled and any appropriate operation the fractures in reset bone B.Device 4800 can be " independently ", and wherein, it can only directly be fixed on patient's health, and is not fixed on other structure or supporting member.Because installing 4800 can be independently, so clinician's manipulation device 4800 freely, to adapt to individual, clinician or treatment location needs and hobby, while hold reset.

Figure 48 B has represented exemplary device 4850.Device 4850 element can have with device 4800(Figure 48 in represent) the common feature of individual features.For example, supporting member 4857 can be corresponding with supporting member 4801.Supporting member 4859 can be corresponding with supporting member 4803.

Device 4850 can comprise support 4855.Support 4855 fixedly represents in soft tissue 4808(Figure 48) prevent from sliding with respect to supporting member 4857.Support 4855 can be for example by the front area of humerus is provided resistance fixedly soft tissue 4808 prevent its slip.

Hinged lock 4853 can fixed support 4859 with respect to position and the orientation of supporting member 4857.When lock 4853 is unblanked, the gap 4851 between supporting member 4857 and supporting member 4859 can be elongated or shorten.

For example, in reset processing process, supporting member 4857 and 4859 can be arranged in basic identical plane.Gap 4851 can be elongated, to apply traction.Supporting member 4859 can be again translation downwards, keep the attitude of supporting member 4859 simultaneously.Supporting member 4859 tilts or rotation with respect to supporting member 4857 again.Then can drive lock 4853, so that fixed support 4859 is with respect to position and the orientation of supporting member 4857.

Figure 49 has represented exemplary device 4900.Device 4900 can have the one or more features common with device 4800.Device 4900 can comprise in supporting member 4803 and 4801(Figure 48 and representing).Device 4900 can comprise spherojoint 4901.Spherojoint 4901 can be fixed on supporting member 4801.Supporting member 4805 can comprise bearing 4903.Bearing 4903 can be configured to receive spherojoint 4901.Spherojoint 4901 can be hinged against a part for bearing 4903.

Supporting member 4801 and 4803 can be arranged to along axis X, Y and Z translation.Supporting member 4801 and 4803 can be arranged to around axis X, Y and Z rotation.Supporting member 4801 and 4803 can be positioned at angle σ.Angle σ can be corresponding to supporting member 4801 relative altitude with respect to supporting member 4803.Supporting member 4801 and 4803 can be positioned at angle φ.Angle φ can be corresponding to supporting member 4801 flat orientation with respect to supporting member 4803 in plane X-Y.

Hold- down screw 4805 and 4905 can be threadedly engaged with base portion 4803.Hold- down screw 4805 and 4905 can be arranged to engage with spherojoint 4901.Hold- down screw 4805 and 4905 can be exerted pressure to spherojoint 4901.Pressure can fixed support 4801 with respect to the position of supporting member 4803.

Figure 50 has represented to install the enlarged drawing 5000 of a part of 4800.View 5000 has represented supporting member 4813.Supporting member 4813 can comprise net 5001.Net can comprise strand 5015 and 5017.Strand 5015 and 5017 can angulation μ.

Stretching knob 5003 can be threadedly engaged with supporting member 4825.Being threadedly engaged with of stretching knob 5003 and supporting member 4825 can be so that spring 5005 presses stretcher 5007.Compression can cause that supporting member stretches along axis T1.Soft tissue 5013 can reduce the value of angle μ with respect to the stretching of net 5001 and traction.

The value that reduces angle μ can increase net 5001 along the length of axis T1.The value that the reduces angle μ T2-T2 compressed web 5001 that can wind the line.The value that reduces angle μ can increase net 5001 facing to the traction of soft tissue 5013.Increase facing to the traction of soft tissue 5011 fixedly soft tissue 5013 with respect to the position of base portion 4801.

Stretcher 5007 can comprise receptor 5011.Hold-down screw 5009 can be arranged to be threadedly engaged with receptor 5011.Hold-down screw 5009 can fixed-bearing component 4813 with respect to the position of stretcher 5007.

Figure 51 has represented exemplary device 5100.Device 5100 can comprise ductility framework 5101.The axle collar 5115,5117 and 5119 can be fixed on ductility framework 5101.

The axle collar 5115 can comprise receptor 5109 and 5123.Receptor 5109 can be configured to receive bone penetrating parts.Receptor 5123 can be configured to receive hold-down screw (not shown).The joint of hold-down screw and receptor can be exerted pressure to the bone penetrating parts being received by receptor 5109.Pressure can bone fixation penetrating parts with respect to the position of the axle collar 5115.

The axle collar 5115 can comprise receptor 5127.Receptor 5127 can have the one or more features common with receptor 5109.The axle collar 5115 can comprise receptor 5129.Receptor 5129 can have the one or more features common with receptor 5123.The axle collar 5115 can be arranged to be fixed in one or more bone sections, for example, in bone section Pa, Ph or Pb(Fig. 3 A, represent).

Handle 5103 can so that the bone section Rao Guduan center of being fixed on the axle collar 5115 locate.Gu Duan center can be corresponding to representing in initial point O1 or O2(Fig. 7).Handle 5103 can so that the axle collar 5115 with respect to the axle collar 5117 location.

Device 5100 can comprise relieving mechanism 5121.Relieving mechanism 5121 can be arranged to from the axle collar 5115 release levers 5103.Handle 5103 can be from the axle collar 5115 dismountings.

The axle collar 5117 can have the one or more features common with the axle collar 5115.The axle collar 5117 can comprise receptor 5111.Receptor 5111 can be configured to receive bone penetrating parts.The bone penetrating parts being received by receptor 5111 can be fixed in bone section.The axle collar 5117 can be fixed with respect to the position of bone penetrating parts.The axle collar 5117 can be fixed in bone section, for example, in bone section Pa, Ph or Pb(Fig. 3 A, represent).

Handle 5101 can comprise one or more features of handle 5103.Handle 5101 can comprise relieving mechanism.Handle 5105 can so that the bone section being fixed on the axle collar 5117 around Gai Guduan center, locate.Gu Duan center can be corresponding to representing in initial point O1 or O2(Fig. 7).Handle 5105 can so that the axle collar 5117 with respect to the axle collar 5115 location.Handle 5101 can be from the axle collar 5117 dismountings.

The axle collar 5119 can comprise one or more features of the axle collar 5115.The axle collar 5119 can comprise receptor 5113.Receptor 5113 can be configured to receive bone penetrating parts (not shown).The bone penetrating parts being received by receptor 5113 can be fixed in bone section.The axle collar 5119 can be fixed with respect to the position of bone penetrating parts.The axle collar 5119 can be fixed in bone section, for example, in bone section Pa, Ph or Pb(Fig. 3 A, represent).

Handle 5101 can comprise one or more features of handle 5103.Handle 5101 can comprise relieving mechanism.Handle 5105 can so that the bone section being fixed on the axle collar 5117 around Gai Guduan center, locate.Gu Duan center can be corresponding to representing in initial point O1 or O2(Fig. 7).Handle 5105 can so that the axle collar 5117 with respect to the axle collar 5115 location.Handle 5101 can be from the axle collar 5117 dismountings.

Ductility framework 5101 can be arranged to keep bone section Pa and Ph with respect to Gu DuanPb position.Device 5100 can be arranged to the fractures resetting in bone B.Device 5100 can be arranged to reset in bone B(Fig. 3 A and represent) fractures Fh and Fa.

Figure 52 has represented exemplary device 5200.Device 5200 can comprise tool tray 5201.Axle X, Y and Z can be three quadrature-axis.

Device 5200 can comprise platform 5203.Platform 5203 can be positioned at fractures Fa and Fh nearside. Bone penetrating parts 5223 and 5221 can be fixed on bone B.

Bone penetrating parts 5223 can be from the side process of groove 5241 and pad 5231.Hold-down screw 5225 can be threadedly engaged with platform 5203.Being threadedly engaged with of hold-down screw 5225 and platform 5203 can be so that pad 5231 presses platform 5203.Hold-down screw 5225 and platform 5203 be threadedly engaged with can fixed platform 5203 with respect to the position of bone penetrating parts 5223.Hold-down screw 5225 and platform 5203 be threadedly engaged with can fixed platform 5203 with respect to the position of bone B.

Bone penetrating parts 5221 can be from the side process of groove 5243 and pad 5229.Hold-down screw 5227 can be threadedly engaged with platform 5203.Being threadedly engaged with of hold-down screw 5227 and platform 5203 can be so that pad 5229 presses platform 5203.Hold-down screw 5227 and platform 5203 be threadedly engaged with can fixed platform 5203 with respect to the position of bone penetrating parts 5221.Hold-down screw 5227 and platform 5203 be threadedly engaged with can fixed platform 5203 with respect to the position of bone B.

Hold- down screw 5227 and 5225 and being threadedly engaged with of platform 5203 platform 5203 can be fixed on bone B.Hold- down screw 5227 and 5225 and being threadedly engaged with of platform 4203 can fixed range D.Distance D can be corresponding to platform 5203 position with respect to bone B.

Device 5200 can comprise housing 5215.Bar 5205 can extend to spherojoint 5209 from housing 5215.Spherojoint 5209 can be arranged to against the bearing 5219 of tool tray 5201 hinged.Spherojoint 5209 is against the hinged tool tray 5201 that can provide of bearing 5219 along three quadrature-axis translations with around the degree of freedom of three quadrature-axis rotation, and these three quadrature-axis are axis X, Y and Z for example.

Knob 5237 can be threadedly engaged with tool tray 5201.Being threadedly engaged with of knob 5237 and tool tray 5201 can be exerted pressure to spherojoint 5209.This pressure can setting tool bracket 5201 along three quadrature-axis or around the position of three quadrature-axis.Pressure can Limit Tool bracket 5201 with respect to the movement of bone B.

Bar 5217 can extend through in platform 5203 Zhong holes 5245 from ball bearing 5211.Spherojoint 5211 can be arranged to against the bearing 5213 of housing 5215 hinged.Spherojoint 5211 against the hinged housing 5201 that can provide of bearing 5213 along three quadrature-axis translations with around the degree of freedom of three quadrature-axis rotation.Spherojoint 5211 is against the hinged tool tray 5201 that can provide of bearing 5213 along three quadrature-axis translations with around the degree of freedom of three quadrature-axis rotation, and these three quadrature-axis are axis X, Y and Z for example.

Knob 5235 can be threadedly engaged with housing 5215.Being threadedly engaged with of knob 5235 and housing 5215 can be exerted pressure to spherojoint 5211.This pressure can stationary housing 5215 along three quadrature-axis or around the position of three quadrature-axis.Pressure can Limit Tool bracket 5201 with respect to the movement of bone B.

Housing 5215 can be along axis L5203 with respect to platform 5203 translations.Housing 5215 can be along axis L5203 with respect to bone B translation.Knob 5233 can be arranged to be threadedly engaged with platform 5203.Being threadedly engaged with of knob 5233 and platform 5203 can be exerted pressure to bar 5217.This pressure can be along the position of axis L5203 stationary housing 5215.Pressure can Limit Tool bracket 5201 with respect to the movement of bone B.

By knob 5237,5235 and 5233 applied pressures can setting tool bracket 5201 with respect to the position of bone B.Tool tray 5201 can be fixed on respect to the position 5261 of bone B inside the outside of bone B.Tool tray 5201 can comprise sleeve pipe 5239.The axis L 5201 of sleeve pipe 5239 can be aligned to corresponding with the axis at position 5261.The position of tool tray 5201 can be fixed into and make axis L5201 corresponding to the axis at position 5261.

Figure 53 has represented exemplary device 5300.Device 5300 can have the one or more features common with device 5200.Device 5300 can comprise the target 5302 of ray impermeable.The target 5302 of ray impermeable can be arranged to be attached on tool tray 5201.Seat 5311 can be arranged to the target of ray impermeable 5302 to be attached on tool tray 5201.

The target 5302 of ray impermeable can be arranged to can be from tool tray 5201 dismountings.

The target 5302 of ray impermeable can comprise extension 5305.Extension 5305 can comprise target 5301.Target 5301 can comprise spoke 5303.Target 5301 can distance of separation 5315.Spoke 5303 and distance 5315 can be arranged to reduce for example, parallax when aiming at the position (position 5261, represent) of bone B inside in Figure 52.

The target 5302 of ray impermeable can comprise extension 5307.This extension 5307 can comprise target 5301.Extension 5305 can be positioned to be basically parallel to the first anatomical structure viewing plane, for example, in plane 200 or 202(Fig. 2 B, represent).Extension 5307 can be positioned to be basically parallel to the second anatomical structure viewing plane, for example, in plane 200 or 202(Fig. 2 B, represent).Extension 5307 is positioned in basic vertical plane.Extension 5305 can regulate with respect to extension 5307.

Tool tray 5201 is along representing in axis X, Y and Z(Figure 52) and around the movement of axis X, Y and Z can so that target 5301 with respect to bone B, locate.Imaging of medical can be for making target 5301 with respect to 5261 location, position of bone B inside.Seat 5311 can be arranged so that target 5301 makes tool tray 5201 with respect to 5261 location, position with respect to the location at position 5261.Seat 5311 can be arranged so that target 5301 will represent in the centre line L b(Fig. 3 A that make tool tray 5201 with respect to bone B with respect to the location at position 5261) location.

Make target 5301 with respect to location, position 5261 can so that tool tray 5201 with respect to representing in the 5261(Figure 52 of position) location.Position 5261 can be inner at bone B.Target 5301 is located with respect to position 5261 can be so that tool tray 5201 aligns with position 5261.Make tool tray 5201 align and can comprise the axial alignment that makes axis L5201 and position with position 5261.After tool tray 5201 is alignd with position 5261, knob 5237,5235 and 5233 can be arranged to locking tool bracket 5201 with respect to the position at position 5261.

Figure 54 has represented exemplary device 5400.Device 5400 can have the one or more features common with device 5200.

Device 5400 can comprise guiding tube 5401.Guiding tube 5401 can be arranged to be attached on tool tray 5201.Guiding tube 5401 can be arranged to from tool tray 5201 dismountings.Guiding tube 5401 can insert in sleeve pipe 5239.

When can being arranged to tool tray 5201 to be located so that guiding tube 5401 is in inserting sleeve pipe 5239, the target 5302 of ray impermeable is arranged to guided surgery operation tool to position 5261.Surigical tool can be rotation Surigical tool (not shown).Sleeve pipe 5403 can guided surgery operation tool.Sleeve pipe 5403 can be arranged to along axis L5201 guided surgery operation tool.

Figure 55 has represented exemplary device 5500.Device 5500 can have the one or more features common with device 5200.

Device 5500 can comprise fixture 5501.Fixture 5501 can be attached on tool tray 5201.Fixture 5501 can comprise guiding channel 5503.Guiding channel 5503 can be configured to receive line bearing part 5505.Line bearing part 5505 can be configured to receive bone piercing elements, for example, in anchoring piece 329 or 326(Fig. 3 B, represent).Bone piercing elements can be fixed in bone section, for example bone section Pa or Ph.

The target 5302 of ray impermeable can be arranged so that tool tray 5201 is so positioned, and in the time of on attaching to tool tray 5201, guiding channel is with respect to position 5261 orientations.The target 5302 of ray impermeable can be arranged so that tool tray 5201 is so positioned, in the time of on attaching to tool tray 5201, in centre line L B(Fig. 3 A of guiding channel 5503 with respect to bone B, represents) orientation.

In the time of on attaching to tool tray 5201, guiding channel 5503 can with position 5261(Figure 52 in represent) axial alignment.In the time of on attaching to tool tray 5201, guiding channel 5503 can be introduced the bone penetrating parts being received by line bearing part 5505 in bone section Pa.The bone penetrating parts being received by line bearing part 5505 can be fixed in implantation piece 300(Fig. 3 B and represent) on.Implantation piece 300 can be configured in the 5261(Figure 52 of position and represent) locate.The bone penetrating parts being received by line bearing part 5505 can be fixed on bone section Pa on implantation piece 300.

Table 3 has been listed for the treatment of device and has been used the exemplary step that can take.

Table 3: the exemplary step that can take is used in the treatment for device

Can comprise a plurality of other steps.Here shown in and the different embodiment of described device can be combined with the different step of method of the present invention, and no matter whether list in table 4.

Therefore, provide here for the preparation of fractured bones so that the apparatus and method of repairing.It will be appreciated by those skilled in the art that the present invention can implement by the mode different from described embodiment, this embodiment is for example explanation, rather than restriction.

The present invention is only limited by claim below.

Claims (118)

1. for a device for the fractures of the bone that resets, described device comprises:

The first bone piercing elements;

The second bone piercing elements; And

Bridging element in bone outside, described bridging element is configured to receive the first bone piercing elements and the second bone piercing elements; And

Maintaining body, described maintaining body be arranged to keep the first bone piercing elements with respect to the primary importance of bridging element and the second bone piercing elements the second position with respect to bridging element.

2. device according to claim 1, wherein: maintaining body comprises elongated pressure distribution parts, described pressure distribution parts are arranged to exert pressure to the first bone piercing elements and the second bone piercing elements, and pressure distribution parts remain on the first bone piercing elements primary importance and the second bone piercing elements is remained on to the second position.

3. device according to claim 2, also comprise: fixed mechanism, described fixed structure is arranged to pressure to send to a part for pressure distribution parts, so that pressure distribution parts remain on the first bone piercing elements primary importance and the second bone piercing elements is remained on to the second position.

4. device according to claim 3, wherein: fixed mechanism comprises hold-down screw.

5. device according to claim 1, also comprises:

The 3rd bone penetrating parts; And

Base portion;

Wherein, the 3rd bone penetrating parts is arranged so that base portion and engages with reference to osteocomma; And

The first bone penetrating parts is arranged so that the first osteocomma with respect to locating with reference to osteocomma.

6. device according to claim 5, wherein: base portion comprises the axle collar, the described axle collar is configured to receive the 3rd bone penetrating parts.

7. device according to claim 6, also comprises: height lock, the height for fixed base with respect to bone.

8. device according to claim 6, also comprises: length is locked, for the length between fixed bridge relay part and the axle collar.

9. device according to claim 5, wherein: the second bone penetrating parts is arranged so that the second osteocomma with respect to locating with reference to osteocomma.

10. device according to claim 1, also comprises: supporting member, and described supporting member is arranged so that base portion and bridging element are rigidly connected, described supporting member defines the recess for the magnetography of bone.

11. devices according to claim 10, wherein: a part for recess and the longitudinal axis of bone are basically identical.

12. devices according to claim 10, also comprise: articulated section, described articulated section makes supporting member be connected with bridging element.

13. devices according to claim 12, also comprise: hinged lock, described hinged lock is arranged to bridging component to be fixed into supporting member and to become the angle of inclination.

14. 1 kinds of devices for the fractures of the bone that resets, described device comprises:

General frame, described general frame has:

The first receptor, for receiving the first bone piercing elements;

The second receptor, for receiving the second bone piercing elements; And

The 3rd receptor, for receiving the 3rd bone piercing elements;

Wherein, the first bone piercing elements and the second bone piercing elements are arranged to make respectively the first osteocomma and the second osteocomma to move with respect to the 3rd osteocomma, and described the 3rd osteocomma is corresponding with the 3rd bone piercing elements;

The first receptor and the second receptor define the First Line that originates from the first receptor;

The first receptor and the 3rd receptor define the second line that originates from the first receptor;

First Line and the second line define acute angle angle.

15. devices according to claim 14, wherein: described angle is in the scope from about 40 ° to about 89 °.

16. devices according to claim 14, wherein: described angle is in the scope from about 45 ° to about 80 °.

17. devices according to claim 14, wherein: described angle is in the scope from about 55 ° to about 75 °.

18. devices according to claim 14, wherein: the first receptor and the second receptor are corresponding to the first anatomical structure half space and the second anatomical structure half space of bone, and the first anatomical structure half space is separated by the plane of substantially dividing bone equally.

19. devices according to claim 18, wherein:

The first anatomical structure half space is anterior half space; And

The second anatomical structure half space is rear portion half space.

20. devices according to claim 18, wherein:

The first anatomical structure half space is palmar half space; And

The second anatomical structure half space is dorsal part half space.

21. devices according to claim 18, wherein:

The first anatomical structure half space is middle half space; And

The second anatomical structure half space is sidepiece half space.

22. devices according to claim 14, wherein: the 3rd receptor is corresponding to substantially dividing bone equally and defining the first anatomical structure half space of bone and the plane of the second anatomical structure half space.

23. devices according to claim 22, wherein:

The first anatomical structure half space is anterior half space; And

The second anatomical structure half space is rear portion half space.

24. devices according to claim 22, wherein:

The first anatomical structure half space is palmar half space; And

The second anatomical structure half space is dorsal part half space.

25. devices according to claim 22, wherein:

The first anatomical structure half space is middle half space; And

The second anatomical structure half space is sidepiece half space.

26. 1 kinds of methods for reseting fracture portion, described method comprises:

The first bone penetrating parts is inserted in the first osteocomma;

The second bone penetrating parts is inserted in the second osteocomma; And

The first bone penetrating parts and the second bone penetrating parts will be distributed to from the latching force of actuator, to the first bone penetrating parts and the second bone penetrating parts are locked on bridging component, described bridging component is across to the second bone penetrating parts from the first bone penetrating parts.

27. methods according to claim 26, also comprise: making bridging component rotation is extremely angle of inclination with respect to the longitudinal axis with reference to osteocomma.

28. methods according to claim 26, wherein: angle is radius inclination angle.

29. methods according to claim 27, also comprise: by base portion pin being connected to reference on osteocomma and bridging component is fixed with described angle of inclination, described base portion and bridging component are rigidly connected.

30. methods according to claim 26, also comprise: regulate base portion with respect to the height with reference to osteocomma, to make the first osteocomma and the rotation of the second osteocomma extremely with respect to the angle with reference to osteocomma.

31. methods according to claim 30, wherein: angle is palmar inclination angle.

32. methods according to claim 30, also comprise: level altitude, so that fixed angle.

33. methods according to claim 26, also comprise: regulate and the position of the 3rd bone penetrating parts engaging with reference to osteocomma with respect to base portion, to be adjusted in (a) first osteocomma and the second osteocomma; (b) with reference to the distance between osteocomma.

34. methods according to claim 33, wherein: described distance is corresponding to radius height.

35. methods according to claim 33, also comprise: fixedly the axle collar is with respect to the position of base portion, so that fixing described distance.

36. methods according to claim 26, also comprise:

By the rigid support of the jagged ray impermeable of tool, come with respect to reference to bone fixed bridge relay part; And

By recess, come the inside of imaging bone.

37. 1 kinds of devices for reseting fracture portion, described device comprises:

Base portion, described base portion is arranged to be fixed on the first osteocomma; And

Osteocomma manipulator, described osteocomma manipulator is communicated with base portion machinery, and is arranged to:

With the second osteocomma positive engagement;

The second osteocomma is moved along three quadrature-axis; And

Make the second osteocomma along each axis rotation in three quadrature-axis.

38. according to the device described in claim 37, also comprises: pressure source, and described pressure source is arranged to fixedly osteocomma manipulator, to substantially prevent:

The second osteocomma moves along three quadrature-axis; And

The second osteocomma rotates around three quadrature-axis.

39. according to the device described in claim 37, wherein: osteocomma manipulator comprises:

Elongated bone penetrating parts; And

The axle collar, the described axle collar is configured to receive elongated bone penetrating parts.

40. according to the device described in claim 39, wherein: osteocomma manipulator also comprises pressure source, and described pressure source is arranged to respect to axle collar locking bone penetrating parts.

41. according to the device described in claim 39, wherein: osteocomma manipulator also comprises collar receiver part, and described collar receiver part is arranged to along following direction translation:

First direction; And

The second direction vertical with first direction.

42. according to the device described in claim 41, wherein: osteocomma manipulator also comprises pressure source, and described pressure source is arranged to respect to collar receiver part lock collar.

43. according to the device described in claim 41, wherein: osteocomma manipulator also comprises pressure source, and described pressure source is arranged to respect to base portion lock collar supporting member.

44. according to the device described in claim 40, wherein: osteocomma manipulator also comprises collar receiver part, and described collar receiver part is arranged to along following direction translation:

First direction; And

The second direction vertical with first direction.

45. according to the device described in claim 44, wherein: pressure source is arranged to respect to collar receiver part lock collar.

46. according to the device described in claim 45, wherein: pressure source is also arranged to respect to base portion lock collar supporting member.

47. according to the device described in claim 42, also comprises: when pressure source is the first pressure source, the second pressure source is arranged to respect to base portion lock collar supporting member.

48. according to the device described in claim 41, wherein: the described axle collar comprises cartridge clip, and described cartridge clip has the hinged surface hinged with respect to collar receiver part, and described pressure source is the screw thread of cartridge clip.

49. according to the device described in claim 48, wherein: it is spherical sweep that described hinged watch mask has basic.

50. according to the device described in claim 40, wherein: the axle collar comprises cartridge clip, and described cartridge clip comprises:

Sleeve body, for receiving elongated bone penetrating parts, described sleeve body has:

External screw thread; And

Keep finger, described maintenance finger is arranged to the bone penetrating parts that keeps elongated;

Convergent shape part, for receiving sleeve body, and compresses maintenance finger against elongated bone penetrating parts; And

Interior threaded part, for engaging with external screw thread, and introduces sleeve body in convergent shape part.

51. according to the device described in claim 50, wherein:

Interior threaded part comprises the first crooked hinged surface, for hinged against collar receiver part; And

Convergent shape part, described convergent shape partly comprises the second crooked hinged surface, for hinged against collar receiver part.

52. according to the device described in claim 51, wherein: convergent shape partly comprises swelling part, and described swelling part is arranged to response by keeping finger to engage with collar receiver part the joint of elongated bone penetrating parts.

53. according to the device described in claim 52, also comprise: brake, described brake has limited in rotary moving with respect to collar receiver part of convergent shape part.

54. according to the device described in claim 53, wherein: brake comprises pin, and described pin partly stretches out from convergent shape, and is arranged for interference collar receiver part.

55. according to the device described in claim 50, wherein: interior threaded part and convergent shape are partly arranged to by keeping finger mutually to remove for the power of described convergent shape part.

56. according to the device described in claim 55, wherein:

Collar receiver part comprises upper board and lower panel; And

Interior threaded part will make upper board remove from lower panel from removing of convergent shape part.

57. according to the device described in claim 56, wherein: base portion comprises framework, and described framework is arranged to limit upper board and is removed from lower panel.

58. according to the device described in claim 57, wherein: cartridge clip is exerted pressure and (b) by collar receiver part, to framework, exerted pressure and lock elongated bone penetrating parts to collar receiver part by interior threaded part and convergent shape part by (a).

59. according to the device described in claim 37, when osteocomma manipulator is that the first osteocomma manipulator and three quadrature-axis are during corresponding to the second osteocomma, described device also comprises: the second osteocomma manipulator, and described the second osteocomma manipulator is connected with base portion machinery, and is arranged to:

With the 3rd osteocomma positive engagement;

The 3rd osteocomma is moved along three quadrature-axis, and these three quadrature-axis are corresponding to the 3rd osteocomma; And

Make the 3rd osteocomma along each three quadrature-axis rotations.

60. 1 kinds of devices for reseting fracture portion, described device comprises:

Ductility framework;

First axle collar, described first axle collar is fixed on framework, and is configured to receive the first elongate bone penetrating parts; And

Second axle collar, described second axle collar is fixed on framework, and is configured to receive the second elongate bone penetrating parts;

Wherein, ductility framework is arranged to keep the second elongate bone penetrating parts with respect to the position of the first elongate bone penetrating parts.

61. according to the device described in claim 60, also comprises:

The first joystick, described the first joystick and first axle collar are rigidly connected; And

The second joystick, described the second joystick and second axle collar are rigidly connected, and the second joystick is arranged so that second axle collar moves to the second position with respect to first axle collar from the primary importance with respect to first axle collar.

62. according to the device described in claim 61, wherein: the first joystick is in use connected with first axle collar, and can disassemble from first axle collar after use; And

The second joystick is in use connected with second axle collar, and can disassemble from second axle collar after use.

63. according to the device described in claim 62, wherein:

First axle collar comprises the first pressure source, and described the first pressure source is arranged to lock the first elongate bone penetrating parts with respect to first axle collar; And

Second axle collar comprises the second pressure source, and described the second pressure source is arranged to lock the second elongate bone penetrating parts with respect to second axle collar.

64. 1 kinds of devices for the fractures of the bone that resets, described device comprises:

The first supporting member, described the first supporting member is arranged to support the first soft tissue, and described soft tissue is corresponding to the first osteocomma;

The second supporting member, described the second supporting member is arranged to support the second soft tissue, and described the second soft tissue is corresponding to the second osteocomma, and the second supporting member is by joint and hinged with respect to the first supporting member; And

Lock, described lock is arranged to anchor tip, to the angle between the first supporting member and the second supporting member is set.

65. according to the device described in claim 64, also comprises:

The first supporting member, described the first supporting member is bearing in the first soft tissue on the first supporting member; And

The second supporting member, described the second supporting member is bearing in the second soft tissue on the second supporting member.

66. according to the device described in claim 65, wherein: the second supporting member is arranged to apply tensile force to the second soft tissue, to make the second osteocomma move away from the first osteocomma.

67. according to the device described in claim 66, wherein: the second supporting member comprises soft tissue grasper.

68. according to the device described in claim 67, wherein: soft tissue grasper is arranged to soft tissue, apply the traction of increase when the second osteocomma increases away from moving of the first osteocomma.

69. according to the device described in claim 64, wherein: joint comprises elongated member, and described elongated member has:

First end, described first end lockably engages with the first supporting member is rotatable; And

The second end, described the second end lockably engages with the second supporting member is rotatable; And

Mobile lock;

Wherein, first end and the second end can move mutually, to be adjusted in the gap between the first supporting member and the second supporting member; And

Mobile locking fixes on the movement between first end and the second end, so that fixed interval (FI).

70. 1 kinds of methods for the fractures of the bone that resets, described bone has portions of proximal and distal part with respect to fractures in body part, and described method comprises:

The portions of proximal of body part is fixed on the first supporting member;

The distal part of body part is fixed on the second supporting member that is connected to the first supporting member; And

Handle the second supporting member to reseting fracture Bu orientation; And

The second supporting member is locked in to described orientation.

71. according to the method described in claim 70, wherein: handle and to comprise and making the second supporting member separated with the first supporting member with time in the essentially identical plane of the first supporting member when the second supporting member.

72. according to the method described in claim 71, wherein: handle and also to comprise and make the second supporting member along the direction translation substantially vertical with the second supporting member.

73. according to the method described in claim 72, wherein: described direction is palmar substantially.

74. according to the method described in claim 73, wherein: when the second supporting member has the first edge and the second edge, handle and also to comprise and make the first edge along palmar direction, deflect to the degree of this any deflection that is greater than the second edge.

75. according to the method described in claim 72, also comprises the second supporting member is rotated with respect to the first supporting member.

76. 1 kinds for making Surigical tool with respect to the device of the spots localization of fractured bones inside, and described device comprises:

Pin, described pin is arranged to penetrate the osteocomma of bone; And

Supporting member, described supporting member is arranged to hinged with respect to pin, and the indication inlet point corresponding with described position.

77. according to the device described in claim 76, wherein: supporting member comprises:

Concave surface, for hinged against pin; And

Indicator, is used to indicate inlet point.

78. according to the device described in claim 77, wherein: supporting member also comprises sleeve fixing part, and described sleeve fixing part is configured to receive pin, and described sleeve fixing part comprises concave surface.

79. according to the device described in claim 76, wherein: supporting member comprises sweep, and described sweep is arranged to be across to from the first anatomical structure direction of bone the second anatomical structure direction of bone.

80. according to the device described in claim 79, wherein:

Bone is radius;

The first anatomical structure direction is dorsal part direction; And

The second anatomical structure direction be front side to.

81. according to the device described in claim 76, wherein: when osteocomma is the first osteocomma, pin is fixed on fixture, and described fixture remains on reset orientation with respect to the second osteocomma by the first osteocomma.

82. according to the device described in claim 76, wherein:

Pin and supporting member define spherical surface when being bonded with each other, and described pin is arranged along the radius of spherical surface;

Supporting member is arranged so that inlet point is positioned near the joining place of soft tissue spherical surface and bone.

83. devices described in 2 according to Claim 8, wherein: pin comprises brake, and described brake defines pin and enters the maximum penetration in osteocomma.

84. devices described in 2 according to Claim 8, wherein: pin comprise brake, described brake define when supporting member and pin joint close described in supporting member with respect to the minimum constructive height of osteocomma.

85. devices described in 3 according to Claim 8, when brake is the first brake, described device also comprises: second brake, described second brake define when supporting member and pin joint close described in supporting member with respect to the minimum constructive height of osteocomma.

86. according to the device described in claim 76, wherein: supporting member comprises:

Fixture, described fixture is arranged to close with pin joint; And

Extension, described extension is arranged to extend away from fixture along spherical track, until near soft tissue extension contact bone.

87. devices described in 6 according to Claim 8, wherein: extension comprises indicator, when indicator is near bone, described indicator indication inlet point.

88. devices described in 7 according to Claim 8, wherein: indicator is extended away from extension along the direction vertical with spherical track.

89. according to the device described in claim 76, also comprise: elongate guide part, described elongate guide part has end and guiding surface, guiding piece and supporting member mechanical coordination, make the end of guiding piece corresponding to inlet point, guiding surface is oriented so that Surigical tool aligns with described position.

90. devices described in 9 according to Claim 8, wherein:

Pin has penetration end, and described penetration end is arranged to be arranged in osteocomma; And

Supporting member is arranged so that guiding piece is oriented so that guiding surface is oriented such that Surigical tool aligns with penetration end.

91. according to the device described in claim 76, also comprises:

The first ray impermeable target on first object arm;

The second ray impermeable target in the second target-arm;

Wherein, described position and inlet point define guiding axis;

First object arm is communicated with pin machinery;

The second target-arm is communicated with pin machinery;

First object arm is arranged to, along the first direction away from guiding axis, first object is bearing in to the first distance; And

The second target-arm is arranged to, along the second direction away from guiding axis, the second target is bearing in to second distance place, and described second direction is basically perpendicular to first direction.

92. according to the device described in claim 91, wherein: first direction and second direction define the plane crossing with described position.

93. 1 kinds for being positioned at the device that enters hole of bone, described in enter the internal cavities Zhong position of hole for implantation piece being sent at bone, described device comprises:

First component, described first component is arranged in the first anatomical structure viewing plane and aligns with described position; And

Second component, described second component is attached on first component, and in the second anatomical structure viewing plane substantially vertical with the first anatomical structure viewing plane with tissue definite point and direction from described to described position organizationally while contact.

94. according to the device described in claim 93, wherein: first component comprises the target of ray impermeable, for first component is alignd with described position.

95. according to the device described in claim 93, wherein:

First component comprises pivot pin end, the rotatably mounted framework of described pivot pin end, and described framework comprises that, for receiving the receptor of bone penetrating parts, bone penetrating parts is arranged to framework to be fixed on the osteocomma of bone; And

Pressure source, described pressure source is arranged so that first component fixes with respect to framework.

96. according to the device described in claim 93, also comprises: pole, and described pole is across to the second anatomical structure observation place from the first anatomical structure observation;

Wherein, first component and second component are elongated; And

First component away from pivot pin end support pole; And

Described pole supporting second component.

97. according to the device described in claim 96, wherein: the rotatably mounted second component of pole.

98. according to the device described in claim 96, wherein: when first component is parallel with second component, second component is than the short length of first component, described length corresponding to:

(a) length of implantation piece; And

(b) distance between the end of second component and the end at described position.

99. according to the device described in claim 96, wherein: second component comprises guiding tube.

100. according to the device described in claim 99, wherein: second component has near the base portion distal openings of guiding tube, and described base portion is placed in contact the outer surface of bone.

101. according to the device described in claim 100, wherein: base portion comprises contact, and described contact is arranged to catch surface, to prevent that base portion is with respect to surface translation.

102. according to the device described in claim 101, and when contact is the first contact, described device also comprises: the second contact, described the second contact is arranged to catch surface, to jointly prevent that with the first contact base portion from rotating with respect to surface.

103. according to the device described in claim 100, wherein: base portion also comprises: the first align unit, and described the first align unit stretches out from the first side of base portion; And second align unit, described the second align unit stretches out from the second base portion, relative with the first side side, and the apparent surface that align unit is arranged to bone engages tangently, to guiding tube is alignd with the longitudinal axis of bone.

104. according to the device described in claim 100, wherein: base portion also comprises: the first sidepiece clamping plate, and described the first sidepiece clamping plate stretch out from the first side of base portion; And the second sidepiece clamping plate, described the second sidepiece clamping plate stretch out from the second base portion, relative with the first side side, and sidepiece clamping plate are arranged to catch the apparent surface of bone, to prevent that base portion from rotating in a circumferential direction around the longitudinal axis of bone.

105. according to the device described in claim 100, wherein: base portion comprises the receptor for bone penetrating parts, thereby bone penetrating parts makes base portion engage with bone.

106. according to the device described in claim 105, when receptor is that the first receptor and bone penetrating parts are while being the second bone penetrating parts, described device also comprises: for the second receptor of the second bone penetrating parts, thereby the second bone penetrating parts makes base portion engage with bone;

Wherein, the first receptor and the second receptor are oblique, so that the first bone penetrating parts and the second bone penetrating parts are fixed on base portion on bone by skew nailing structure.

107. according to the device described in claim 100, also comprises:

The target of the first ray impermeable, for making the pivot pin end of first component align with described position; And

The target of the second ray impermeable, for making base portion align with described position;

Wherein, the target of the second ray impermeable is stretched out from base portion, and is substantially in the second anatomical structure viewing plane.

108. according to the device described in claim 100, also comprises: bone penetrating parts guiding piece, and described bone penetrating parts guiding piece is supported by base portion, and aligns with guiding tube;

Wherein, framework is arranged to the first osteocomma to be fixed on the second osteocomma;

Base portion is placed in contact the first osteocomma; And

Bone penetrating parts guiding piece is arranged to guide bone penetrating parts to enter in implantation piece through the second osteocomma, to the second osteocomma is anchored on implantation piece.

109. one kinds of devices, comprising:

Instruction unit, described instruction unit is corresponding to the first position on bone, the spaced apart basic distance uniformly of internal point in described the first position and bone, described internal point is corresponding to the position of bone implantation piece; And

Joint element, described joint element stretches out away from instruction unit, joint element is arranged to rotate around pin, described pin is fixed with respect to bone, and be oriented with bone at angle;

Wherein, the variation of angle makes instruction unit corresponding to the second position on bone, and described the second position is different from the first position, and with the spaced apart basic distance uniformly of internal point.

110. according to the device described in claim 109, wherein: basic distance is uniformly corresponding to the length of implantation piece.

111. one kinds of devices, comprising:

Instruction unit, described instruction unit is corresponding to Gu Shang position, the spaced apart basic distance uniformly of internal point in described position and bone, described internal point is corresponding to the position of bone implantation piece; And

Joint element, described joint element stretches out away from instruction unit, and joint element is arranged to rotate around pin, and described pin is fixed with respect to bone;

Wherein, described basic distance is uniformly irrelevant with the angle that pin is fixed on bone.

112. according to the device described in claim 111, wherein: basic distance is uniformly corresponding to the length of implantation piece.

113. one kinds near the position in bone inside being positioned at orthopedic tool the device of bone outside, and described device comprises:

Tool tray, described tool tray defines three quadrature-axis; And

Bearing assembly, described bearing assembly comprises:

Platform, described platform is arranged to away from bone location, and engages with the osteocomma of bone; And

Adjusting rod, described adjusting rod makes bearing assembly be connected with tool tray;

Wherein, bearing assembly is arranged near described position at bone external support tool tray; And

Tool tray can be along each axis translation in three axis, and each axis rotation that can be in three axis.

114. according to the device described in claim 113, wherein: adjusting rod comprises:

Housing;

The first bar, described the first bar extends to the first spherojoint tool tray from housing; And

The second bar, second spherojoint of described the second bar from housing extends in the hole of bearing assembly.

115. according to the device described in claim 114, wherein: housing can be by the second bar and with respect to platform translation and rotation.

116. according to the device described in claim 113, also comprises: the target of ray impermeable, the goal setting of described ray impermeable becomes to be attached on tool tray, for tool tray is alignd with using the position of imaging of medical.

117. according to the device described in claim 113, also comprises: guiding tube, and described guiding tube has:

Fixture, described fixture is arranged to Yi Yi orientation and is attached on tool tray; And

Sleeve pipe, described sleeve pipe based on described orientation and with the axial alignment at described position, and be arranged to rotation Surigical tool to guide to described position.

118. according to the device described in claim 113, and when osteocomma is the first osteocomma, described device also comprises: bone penetrating parts guiding piece, and described bone penetrating parts guiding piece has:

Fixture, described fixture is arranged to Yi Yi orientation and is attached on tool tray; And

Guiding channel, the axial alignment of described guiding channel based on described orientation and described position, guiding channel is arranged to guide bone penetrating parts to enter in implantation piece through the second osteocomma, to the second osteocomma is anchored on implantation piece.

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